Although you may be healthy, you never know when illness will strike, or you’ll sustain an injury in an accident. Having health insurance coverage is important in case of a medical emergency, no matter your age. Working in a doctor’s office, too many times I see so many patients without insurance. It could be as simple as they didn’t know about these options and how it could help them.
Open enrollment is happening now and a great time to look into insurance if you don’t have it.
These five tips can help you get coverage through the Affordable Care Act.
- Shop Instead of Renewing – About a quarter of those who have health insurance through the Affordable Care Act (ACA) automatically renew to the same plan as they had the previous year. However, instead of doing that, you should study your plan options to make sure you’re getting the best coverage.
Some insurance companies change plans, and as the law changes, they may drop some of them as well. Take the time to go over each plan to ensure you’re getting the best coverage available at the best price. There could easily be a better option available for the new year. - Know What the Coverage Includes – When you have coverage through an ACA plan, it must provide coverage for what are considered essential services. These services include:
Doctor’s services, Emergency care, Hospitalization and outpatient services, Prescription drugs, Pregnancy, maternity, and newborn care, Mental healthcare, Rehabilitative and habilitative services, Lab services, Pediatric care, Preventative, wellness care, and chronic disease management.
In addition, insurance companies cannot refuse to cover someone due to pre-existing conditions. So, if you have a chronic disease, cancer, or other medical issues, you can still get a healthcare plan. - Apply During Enrollment – The ACA has an open enrollment period in which anyone who qualifies for a plan can apply for one and enroll when they find suitable coverage. For coverage during 2019, the open enrollment period is November 1, 2018, through December 15, 2018.
Some people may qualify for Special Enrollment Periods (SEP) if they lose healthcare through their employer or undergo life events like moving, marriage, or growing their families by having babies or adopting children. However, they only have 60 days to enroll during a SEP. - Check Qualifications for Financial Help – When shopping for a plan through the ACA, make sure to check your eligibility for financial help to lower the premium costs. The estimate is that 8 out of 10 people can get a tax subsidy to help them pay for coverage for themselves and their families.
However, it is important to update your income if it changes to ensure you’re getting the correct tax subsidy. If not, and you get too much of a subsidy, then you will need to repay it when filing taxes the next year. - Understand the True Costs – The plan with the lowest premium isn’t always the best one for you. You should read each plan carefully to understand the premium, out-of-pocket maximum, copay costs, deductibles, and coinsurance.
If you don’t understand these terms, you can get help by calling the Healthcare Marketplace. The telephone number is listed on the home page of Healthcare.gov.
Having affordable health insurance is important whether you’re single or have a family. Life is unpredictable, and you could need hospitalization or health services for a chronic condition. Fortunately, you can get affordable healthcare through the ACA for when you need it.
