Health Insurance
FAQs

Have Questions?

Many people are confused by health insurance. But it doesn’t have to be this way. Browse our FAQs and give us a call if you still have questions.

Health Insurance FAQs
  • General

  • How do I get health insurance?

    If your employer does not offer health insurance or if you are self-employed, you will have to get “private” health insurance. Buying individual insurance allows you to tailor a plan to fit your needs from the insurance carrier of your choice. It requires careful shopping, because coverage and costs vary from company to company. When evaluating plans, consider what medical services are covered, what benefits are paid, and how much you must pay in deductibles and coinsurance. You can keep premiums down by accepting a higher deductible. Click here to get a health insurance quote.

  • What is the first thing I should know about buying health coverage?

    Your first priority should be to insure yourself and your family against the most catastrophic and financially disastrous losses that can result from an illness or accident. If you are offered health benefits at work, carefully review the plans’ literature to make sure the one you select fits your needs. If you purchase individual coverage, buy a policy that will cover major expenses and pay them to the highest maximum level. Save money on premiums, if necessary, by taking large deductibles and paying smaller costs out-of-pocket.

  • When is Open Erollment?

    For 2017, open enrollment is from November 1st, 2016 to January 31st, 2017. However, there are a few dates that need to be noted.

    • November 1, 2016: Open Enrollment begins — You can enroll, renew, or change your health insurance plan for 2017.
    • December 15, 2016: Last day to change plans or enroll in a new plan for coverage to beginning January 1st, 2017.
    • January 31, 2017: Last day to signup or change a plan for 2017. After this date, to enroll or change plans, you will need to qualify for a Special Enrollment Period.

    In addition, when you apply during the month impacts when your coverage will begin. For example, if you enroll in a health plan on January 10th (prior to the 15th of the month), your coverage will begin on February 1st. However, if you apply after the 15th, your coverage will not begin until March 1st.

  • Can children be insured on a family health insurance policy?

    Under Obamacare, health insurance policies will typically insure dependent children of the policyholder through age 26 if they are enrolled as a full time student. Otherwise they are required to obtain their own insurance.

  • What is the Special Enrollment Period (SEP)?

    SEP is a period outside of the annual Open Enrollment Period when you can sign up for health insurance. You must qualify for a Special Enrollment Period. In order to qualify, you must have had certain Qualifying Life Events, such as losing health coverage, moving, getting married, having a baby, or adopting a child.

    If you qualify for an SEP, you generally will have up to 60 days following the event to enroll in a plan. If you miss this window, you will have to wait until the next Open Enrollment Period to apply.

  • What are Qualifying Life Events?

    If you miss the Open Enrollment Period, you’ll need to have a “qualifying life event” in order to enroll in a new major medical health plan or change your existing health insurance coverage. Some examples are losing health coverage from an employer, moving or getting married. To view a complete list, click here.

  • Can I buy a single health insurance policy that will provide all the benefits I’m likely to need?

    Generally speaking, no. Although you can select a plan or buy a policy that can cover most medical, hospital, surgical, and pharmaceutical bills, no single policy covers everything. In addition to health insurance, you may want to consider additional single-purpose policies like long-term care or disability income insurance. If you are over 65, you may want a Medicare Supplement/Medigap policy to fill in the gaps in Medicare coverage.

  • What is a deductible?

    A “deductible” is a set dollar amount your that health insurance plan will require you pay out-of-pocket each year before receiving any benefits. However, not all health insurance plans require a deductible, such as most HMOs.

  • What is the difference between in-network and out-of-network providers?

    Think of “in-network” vs. “out-of-network” as having a relationship with the provider or not having a relationship with the provider. An in-network provider (has relationship) is one contracted with the health insurance plan to provide services to members at a pre-negotiated rate. An out-of-network (no relationship) provider is one not contracted with the health insurance plan. Typically, if you visit a physician or other provider within the network, the amount you pay will be less than if you went to an out-of-network provider. However, some insurance plans offer coverage for services from out-of-network providers, but at a lesser amount than in-network providers.

    Typically, PPO, HMO and POS plans implement provider networks. Indemnity plans do not.

  • What is co-insurance?

    Coinsurance refers to the amount that you are required to pay for a medical claim after you have met your deductible. For example, assume your health insurance plan has a $500 deductible and 30% coinsurance requirement (and does not have any additional co-payment requirements). You receive a $1,500 medical bill for services you received. What would you be responsible for paying? First, you must meet your deductible ($500). The remaining amount due is now $1,000. This is where the co-insurance kicks in. You would be responsible for 30% of the $1,000 or $300. Your total responsibility for this claim would be $800.

    Now, let’s say you require medical service within the same calendar year. This claim is $1,000. How much would you owe? $300. Because you already met your $500 deductible earlier in the year, the co-insurance amount is your only responsibility. The deductible resets every calendar year. Co-insurance does not include co-pays.

  • What happens to my insurance if I lose my job?

    If you have had health coverage as an employee benefit and you leave your job, voluntarily or otherwise, one of your first concerns will be maintaining protection against the costs of health care. You can do this in one of several ways:

    • First, you should know that under a federal law (the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly known as COBRA), group health plans sponsored by employers with 20 or more employees are required to offer continued coverage for you and your dependents for 18 months after you leave your job. (Under the same law, following an employee’s death or divorce, the worker’s family has the right to continue coverage for up to three years.) If you wish to continue your group coverage under this option, you must notify your employer within 60 days. You must also pay the entire premium, up to 102 percent of the cost of the coverage.
    • If COBRA does not apply in your case—perhaps because you work for an employer with fewer than 20 employees—you may be able to convert your group policy to individual coverage. The advantage of that option is that you may not have to pass a medical exam, although an exclusion based on a pre-existing condition may apply, depending on your medical history and your insurance history.
    • If COBRA doesn’t apply and converting your group coverage is not for you, then, if you are healthy, not yet eligible for Medicare, and expect to take another job, you might consider an interim or short-term policy. These policies provide medical insurance for people with a short-term need, such as those temporarily between jobs or those making the transition between college and a job. These policies, typically written for two to six months and renewable once, cover hospitalization, intensive care, and surgical and doctors’ care provided in the hospital, as well as expenses for related services performed outside the hospital, such as X-rays or laboratory tests.
    • Starting in 2014, indiviudals will be able to go to their state’s “health insurance exchange” to get coverage and not be denied or rated due to pre-existing conditions. Learn more about health insurance exchanges.
  • What is Obamacare? What is Health Care Reform?

    “Obamacare”, formally known as the Patient Protection & Affordability Care Act (PPACA), is legislation signed into in 2010 which will require all US citizens obtain health insurance or pay a penalty starting in 2014. States will have to create and manage their own health insurance marketplace known as, “health insurance exchanges”, where individuals and businesses can obtain health insurance regardless of any pre-existing conditions. If you are a business owner, depending on the number of people you employee, you may be required to provide health insurance benefits to all of your employees or pay a penalty per employee. If you already offer your employees health care benefits, you may be eligible for a tax credit. It is important to make sure you are compliant with PPACA’s requirements.

  • Who can I contact if I have questions?

    Getting health insurance can be frustrating. Making sure you are getting the benefits you need within a means that fits your budget can be a complcated and confusing process.

    ChooseMyPlan has been helping individuals and businesses with their health insurance needs for over 25 years. We can help:

    • Explain health insurance benefits and how they work.
    • Perform cost comparisons to make sure you are not paying too much for your current or new plan.
    • With the entire application process, whether you are applying on the exchange or off.

    Contact us today: 888.430.7510 or email us at contact@choosemyplan.com.

  • HSA (Health Savings Accounts)

  • How do I qualify for an HSA?
  • What is a High Deductible Health Plan (HDHP)?
  • How much can I contribute to my HSA?
  • Are contributions to an HSA tax deductible?
  • Does the money in Health Savings Accounts rollover?
  • Are distributions from an HSA taxable?
  • Health Insurance Marketplace

  • What is the Health Insurance Marketplace?
  • Are health plans cheaper in the Marketplace?
  • Dental Insurance

  • How does dental insurance work?
  • What is a Dental PPO Plan?
  • What is a Dental HMO Plan?
  • Vision Insurance

  • What is Vision Insurance?
  • Why do I need vision insurance?
  • Why is eye-care important?
  • Can I purchase a plan for myself and my dependent(s)?
  • Which insurance carrier should I choose?
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Paying Too Much For Health Insurance?

Health insurance is expensive. If you feel like you are getting robbed, browse health plans from all insurance carriers each year to ensure you are getting the best price. Also verify your eligibility for premium assistance from the government.

health insurance faqs