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Five Most Frequently Asked Health Insurance Questions

1. Question: Where do I go to acquire health insurance?
Answer: First, contact a local health insurance broker. Choose one with experience with health plans on-exchange and off-exchange. On-exchange plans are ones that are acquired through the Marketplace. A broker can help you navigate through the Marketplace registration process and help you choose a plan. There is no cost to you to have a broker. Seeking the help of a broker is the best way to ensure you know all of the options for and you and your family.
2. Question: Why do I have to have health insurance?
Answer: It’s the law (ACA). Everyone now has access to health insurance, regardless of pre-existing health conditions. This is called guaranteed issue. If you do not have qualified “minimum essential coverage” you will be subject to a tax penalty.
3. Question: Can I keep my Doctor?
Answer: In most cases, yes. The insurance carriers have contracted with “network providers” to negotiate the lowest costs for medical services. In some cases you will be able to choose an out of network provider, but the insurance company will cover less of the costs for services.
4. Question: How do I choose the best insurance plan for me? For example, what are the premiums, offices visit costs/co-pay, deductible, prescription costs, annual maximum out-of-pocket, and network of general doctors and specialists?
Answer: Start with how much you can afford each month. Then ask yourself, am I taking any prescriptions? If yes, make sure and pick a plan that covers prescriptions before having to meet the deductible. Ask yourself, how often do I or other family members see a doctor? If it’s more than 3 times a year it’s wise to pick something with just a co-pay to cover the cost of an office visit. And remember, the less you pay per month the more risk you take on (i.e., higher deductibles etc…), the more you pay the less risk you have. (i.e. lower deductibles, co-pays for Rx and doc visits). Be sure to consider a High Deductible Health Plan (HDHP) as a viable health insurance alternative. If you enroll in a HDHP you can then fund a Health Savings Account (HSA) with pre-tax dollars that can be used to pay for medical expenses.
5. Question: Can I get health insurance anytime I want?
Answer: You can enroll in your company’s group health plan when you are first eligible (in most cases you will need to satisfy a new hire waiting period before coverage will begin) or during the renewal period. You can only purchase private health insurance during the Annual Open Enrollment Period each year, which starts Nov. 1 and ends Jan. 31. This means you cannot enroll in private health insurance until open enrollment period, unless you have a Qualified Special Enrollment event (involuntary loss of other coverage, moving from one county to another, etc.).

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