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Your Top Health Insurance Questions Answered
Admin • Jun 02, 2019
What do you need to know about healthcare and health insurance? If the near-dizzying array of jargon has you confused about your potential coverage, take a look at the top health insurance questions answered.
What Is the Affordable Care Act?
The Affordable Care Act (ACA), also known as Obamacare, is legislation that makes affordable health insurance available and accessible to more people and provides some consumers with tax credits to lower the overall costs. The ACA also does the following:
- Removes pre-existing condition clauses. Prior to the ACA, health insurance companies could exclude you from some types of plans/coverages based on what they termed pre-existing medical conditions. This made it near-impossible (or prohibitively expensive) for people with some conditions to purchase insurance.
- Set a standard for benefits. Low-cost insurance available before the ACA was cheaper for reason. These policies didn't cover much, leaving consumers paying hefty bills. The ACA requires policies to provide minimum essential health benefits.
- Extends children's benefits. The ACA allows children up to age 26 to remain on their parents' health insurance plans.
- Provides free preventative exams. Annual wellness exams at your family physician's office are now free of charge.
- Offers a variety of options. You can find multiple levels of plans on the exchange. These include different types of coverage, different deductibles, and different overall costs.
Even though the ACA has made getting insurance easier for many people, navigating the system is still confusing to many adult Americans. Your insurance agent can help you to compare plans and make the decision that's right for you and your family.
What Is Open Enrollment?
You may have seen commercials, gotten robo-calls, or heard in another way about the open enrollment period. This is a window of time when you can sign up for new insurance plans or make changes to your current plan. Unless you have employer-sponsored health insurance (employers typically have their own enrollment times), you'll need to follow the period the U.S. Department of Health and Human Services' sets.
While most adults need to purchase health insurance during open enrollment, you may start a new policy (or make changes to an existing one) at other times during the year if you meet Qualifying Life Event (QLE) criteria. These events include:
- Marriage. Single adults may need to purchase a family policy or add a spouse after a marriage.
- Divorce. If both you and your spouse were on the family policy, you'll need new coverage after your divorce is finalized.
- Having a baby/gaining a dependent. The birth or adoption of a child will change your insurance needs.
- Losing a family member. Losing a spouse or dependent also requires a change of policy.
If you're not sure when to enroll or when you can make changes to an existing policy, ask your insurance agent. The insurance professional can guide you through the initial process and help you if you meet QLE change criteria.
Is It Better to Choose Low-Cost or Low-Deductible Insurance?
There's no easy answer to this question. Some individuals or families come out on top financially by opting for a lower priced health insurance policy, while others need one that comes with a low deductible.
Before making any decisions, make sure you understand the terminology. The deductible is what you'll pay prior to the insurance taking over the costs. This differs from co-payments - which typically won't count towards your policy's overall deductible. If you're not sure which way to go, consider:
- Your current financial needs. If you don't have the money to pay for a pricier, low-deductible plan, a less expensive, high-deductible one gives you the mandatory coverage you need right now.
- Your medical needs. If you, or a family member, has high-cost medical needs, a low-deductible policy may save you money over time.
- The unexpected. If you can afford a lower-deductible policy, you won't need to worry about unexpected illness or accidents.
Again, talk to your insurance agent before choosing a policy. They'll help you to weigh the pros and cons of low-cost and low-deductible coverage.
Do you need help choosing a new health insurance policy? Contact S. N. Anthony Inc. for more information.
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S.N. Anthony Insurance Inc.
104 S. Washington St.
Ripley, TN 38063
110 S. Church Street
Halls, TN 38040
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