Understanding Health Insurance
What is health insurance?
The purpose of health insurance is to spread the risk of health care costs across a large population. You pay health care companies monthly payments (called "premiums") a set amount of money each month - and you get benefits to pay for your eligible health care expenses in return.
In general, the higher the premium, the lower the out-of-pocket costs to the individual.
What is covered under Affordable Care Act (ACA) health insurance plans?
The costs that are covered range from routine doctor checkups to treatments for long-term illnesses.
However, ALL individual major medical plans sold nowadays must meet the requirements of the Affordable Care Act (ACA), including the "10 Essential Benefits:" These are:
- Ambulatory patient services (outpatient services such as doctor visits)
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Even though it’s called individual health insurance, these also include plans to cover entire families
Is there an alternative to ACA plans that might be less expensive?
Yes, there is! For some, what is know as short-term health plans might be a viable and less expensive option, particularly for those who are not eligible for premium subsidies to lower the cost of ACA plans. Coverage length on short-term plans varies from state to state, but they can offer coverage for as long as three years in certain states. We will be glad to discuss pros and cons of this alternative to ACA plans to see if they're a fit for you.
Why have health insurance?
Why have health insurance?
Because health care costs can be incredibly expensive, it’s a smart idea to have health insurance so you’re prepared for medical expenses. And now, under the ACA, having health insurance is required by law. You may pay a penalty if you don’t have qualified health care coverage.
What if I can't afford to buy health insurance?
Assistance is available to help cover the monthly premium costs for those who fall within certain income ranges. It is well worth contacting a qualified insurance agency (such as Health Insurance Solutions!) to see if your income would allow you to be eligible for a tax credit to offset the cost of health insurance.
At Health Insurance Solutions, we will help you with the entire application process from subsidy eligibility, to choosing a plan, to completing your insurance application. In almost all cases, this can all be completed over the phone.
At Health Insurance Solutions, we will help you with the entire application process from subsidy eligibility, to choosing a plan, to completing your insurance application. In almost all cases, this can all be completed over the phone.
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