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Frequently Asked Questions
For some, buying health insurance can be a confusing and overwhelming process. First, you have to find a health insurance plan within your budget. Then you have to contact the company or an insurance agent in order to get a quote. Once you have all of that information, you can evaluate your options. It is a very personal and complicated process, but there are ways to simplify it.
Now that the Affordable Care Act (sometimes referred to as “Obamacare”) is in place, it is much easier to find a health insurance plan based on your income and personal health needs. In most states, you may even qualify for financial subsidies. You can quickly and easily apply for coverage through the new Healthcare Marketplace.
Before you settle on a plan, you should first get a quote, find a price, and discover any out-of-pocket expenses your plan will expect you to pay (such as deductibles, co-insurance, and copay charges). Once you have all of this information together, it will be easier to find coverage which fits your needs.
The passage of the Affordable Care Act established the Healthcare Marketplace. There are two distinct divisions - a state level, and a federal level. 37 states are members of the federal exchange, and 14 are limited to a state exchange. Unfortunately, not all insurance companies are required to provide information about their plans and prices to the Healthcare Marketplace, so be prepared to do some local searching for affordable plans in your area.
The Healthcare Marketplace may also be referred to as the Health Insurance Marketplace. It is a website managed by the federal government. When you visit, you can enter a few personal details about yourself and start shopping for plans in a matter of minutes.
The Health Insurance Exchange is the pool of health care plans and providers which are cooperating with the federal government in order to provide affordable health insurance to Americans in many states. 37 states are members of the Exchange on the federal level: AL, AK, AZ, AK, DE, FL, GA, HI, IL, IN, IA, KS, LA, ME, MI, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, PA, SC, SD, TN, TX, UT, VA, WV, WI, and WY.
To see if you qualify for a tax subsidy, you need to enroll on the Healthcare Marketplace website (either the federal one, or your state’s website). If you do not qualify for a subsidy for whatever reason, you have the option of shopping through the Exchange or in your state’s private marketplace.
Keep the following terms in mind, as they will help make the search for insurance easier:
- Obamacare - a nickname (sometimes considered derogatory) for the Affordable Care Act. Its full name is the Patient Protection and Affordable Care Act. It was signed into law by President Barack Obama in March of 2010.
- Healthcare Marketplace - a resource for those without health insurance to find affordable coverage through either a state or federal exchange.
- Subsidized Health Insurance - The passing of the Affordable Care Act began the process of subsidizing (offering at a lower cost) health insurance plans for those who cannot otherwise afford health insurance and medical care.
- Medical Insurance - another term for health insurance. Also synonymous with healthcare plans and medical coverage.
- Health Insurance Companies - companies which underwrite (provide) health insurance plans. They are responsible for paying out claims when their beneficiaries (customers) receive medical care.
- Health Insurance Quotes - most health insurance companies are required to give you an accurate estimate of what you should expect to pay as well as the terms of your health insurance plan, should you decide to do business with them. These estimates are commonly referred to as a “quote”.
- Premium - the monthly cost you must pay to maintain your health insurance coverage. Also sometimes referred to as a “monthly premium”.
- Deductible - a fixed dollar amount your insurance company will require you to pay out-of-pocket for your medical care before they will pay out any claims. The deductible and monthly premium are inversely related: the higher the premium, the lower the deductible, and vice versa.
Right now, there are hundreds of different health insurance companies participating in the Exchange offering thousands of different plans. These companies are rated on a letter grading scale (A, B, C, etc.) based on their performance.
Their grade is calculated by attributes such as financial stability, claim payments, and customer service. You might also want to ask around among friends, family members, and colleagues. If their plans are working for them, they could work for you too. Here is a list of some companies that our partners work with: Aetna, UnitedHealthCare, Humana, BCBS, Cigna, Anthem, AARP, and many others.
If you cannot purchase insurance, it will be extremely difficult to find Healthcare options in your area. Many doctors don't accept patients without insurance and hospitals have the tendency to charge higher rates to customers without insurance. In emergency situations, you will be treated, but you will have little protection from the bills that the hospital charges you.
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