2023 Health Insurance

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Popular Questions

If you have questions, you have you covered.

The process of buying health insurance can be a confusing and overwhelming at times. We can help make it easier. To start, you have to find health insurance plans that fit within your budget. The easiest way to start is to speak with an insurance agent in order to get quotes. They can answer your questions and provide you with information for you to consider. Then you can use all that information to evaluate your health insurance options. It is definitely a very personal and complicated process, but there are ways to make it easier.

With the Affordable Care Act (sometimes called “Obamacare”) in place, it is much easier to find a health insurance plan. An agent can use your income and personal health needs to recommend some of the best plans for you. In most states, you may even qualify for financial subsidies. The guidelines for 2023 have changed significantly and more people qualify than ever before.

Before you decide on a plan, you should first get a quote, find a price, and consider all of the potential costs of the plan. Make sure to think about any out-of-pocket expenses your plan will expect you to pay (such as deductibles, co-insurance, and copay charges). With all of those facts together it becomes much easier to select a health insurance plan that fits your needs and your budget.

You can sign up or change marketplace health insurance plans each year during the Open Enrollment Period. It runs from November 1st through January 15th each year. It’s important to know that to start a new plan on January 1st of the year, you must be enrolled by December 15th. If you sign up between December 16th and January 15th the coverage will begin on February 1st.

If you don’t act by January 15th, you can’t get coverage for the year unless you qualify for a Special Enrollment Period.

That is a great question! It always helps to have a checklist of things to ask about to make sure you are getting the facts about your health insurance options. Here is a basic checklist you can use.

  • Is this an indemnity or a managed care plan?
  • How much do I have to pay out-of-pocket annually for medical care?
  • Is there a co-pay for doctor visits? If so, what is it? Is there a separate co-pay for specialists?
  • Can I continue seeing my current doctors? Are they in the network for this plan?
  • Are preventative or routine exams covered?
  • Does this plan include dental, vision care, and other special services?
  • Does the plan cover pre-existing conditions? If not, what’s excluded?

There are a number of different health plan options for you to consider. They are all a little different and provide help with medical costs in different ways.

Affordable Care Act (ACA) Plans: These are health insurance plans that provide comprehensive plans to enrollees and are required by law to meet a minimum standard of essential coverage. That essential coverage includes preventative and wellness care, emergency services, hospitalization coverage, maternity & newborn care, prescription drug coverage, and more. These were defined by the healthcare reform law, known commonly as ACA or Obamacare, and were designed to make healthcare more affordable and to provide coverage to everyone, including those with pre-existing conditions.

Short-Term Plans: A short-term health insurance, sometimes called temporary health insurance, is designed to provide some coverage for a limited period of time and isn’t required to meet the minimum essential coverage guidelines that ACA plans meet. Because they are subject to medical underwriting, short-term plans may not cover pre-existing conditions. Typically these plans make sense when someone is unable to apply for an Affordable Care Act plan because they missed the enrollment deadlines or is waiting for other types of coverage to start (like a new job, Medicare, etc). Check the details of your plan before enrolling to ensure you’re properly covered.

Fixed Indemnity Plans: These plans are designed to supplement health insurance by reimbursing you for out-of-pocket expenses incurred on covered medical treatments and procedures. However, like short-term plans, fixed indemnity plans often don’t cover pre-existing conditions. Also, the amount of costs reimbursed to you could affect your Medicaid eligibility (if applicable). These plans are not true health insurance.

Community or Cost-sharing plans: There are some community/cost-sharing plans that exist but these are not the same as health insurance. They provide medical coverage plans by pooling the funds of like-minded individuals and sharing in the medical costs of the community members. Typically they require individuals to committ to a health lifestyle to join the plan.

Different coverage levels of ACA Health Insurance

Insurance Company Pays: 60%

You pay: 40%

Insurance Company Pays: 70%

You pay: 30%

Insurance Company Pays: 80%

You pay: 20%

Insurance Company Pays: 90%

You pay: 10%

There are 4 different coverage levels to ACA Health Plans. Due to their names (Bronze, Silver, Gold, and Platinum), sometimes they are called metal plans. The good news is that each of them offer the same essential benefits! What changes between them is how much you pay for medical expenses versus what the plan covers for you.

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