All catastrophic, bronze, silver, gold, and platinum plans offer free or discounted visits to the doctor for things like routine checkups or vaccinations and some preventive care. Most plans also offer discounts on prescription drugs and other services. Specific benefits differ from plan to plan, though, so you'll need to learn what each plan offers. Think about what's important to you and your family and make a decision based on how well the plan meets your needs.
Once you've signed up for a plan and paid the first month's premium, you or your child can start using the insurance. The insurance company should send you and everyone covered by your policy insurance cards with your policy number and other information. If you or your child need to see a doctor or go to a hospital before you receive your card, call your insurance company first to make sure your family has been entered into their system. You should also make sure that any doctor you choose for you or your child is in your insurance plan's network.
A network is made up of doctors, specialists, and other health care providers who have agreed to work with your insurance company when it comes to payments and services.
If you take your child to a doctor who isn't in your plan's network, you may have to pay full price for some services. Ask around and learn what you can about the primary care physicians in your plan's network, and then choose a doctor you like. Once you've done that, schedule checkups and use your insurance to help keep your family healthy. Reviewed by: Steven Dowshen, MD. Larger text size Large text size Regular text size.
Here's what to do to get health insurance. Getting Started Before you look for a health insurance plan, check to see if you or your child can get coverage some other way. You'll need to know a few things about each person applying for coverage. Be ready to provide: Social Security numbers or document numbers for legal immigrants information about employers and income policy numbers for any current health insurance plans If you have a job that offers health insurance but you're not happy with it, you can choose to get coverage through healthcare.
This includes income from jobs and other sources like: Social Security unemployment retirement accounts property rental alimony If you pay alimony or interest on student loans, you can deduct the amount you pay when you fill out your application. What Happens Next? These are the basic levels of coverage: Catastrophic insurance is designed to protect an otherwise healthy person in the event of a major injury or illness. It's available only to people under age 30 and those who are exempt from other plans due to hardship.
This type of insurance can have low premiums but very high deductibles. In , President Obama signed the Affordable Care Act ACA into law, which made private health insurance significantly more accessible to uninsured Americans and expanded eligibility to Medicaid. Employer-sponsored health insurance is a health plan chosen and primarily paid for by your employer.
These plans are also offered to or can include your dependents usually spouses and children. Your employer chooses which plan options are available to you and splits the cost of premiums. You can also pay your premiums on a pre-tax basis, which lowers your taxable income. Individual health insurance, also known as a personal health plan, is a policy you buy either for yourself or your family.
These plans allow you to find coverage that best suits your needs and may include your preferred doctors and hospitals. You can renew or change your health insurance plans or options annually. Medicare is a federal program that provides health insurance for people over 65 and for people under 65 with a disability, end-stage renal disease or amyotrophic lateral sclerosis ALS. Medicaid is a state and federally run program that provides health insurance to eligible low income Americans, pregnant women, children, people with disabilities and elderly adults.
You may be dually eligible for Medicare and Medicaid. The Health Insurance Marketplace was established by the Affordable Care Act in to provide insurance plans to individuals, families and small businesses.
Through this online resource, you can learn more about health insurance, compare plans, enroll in a plan and more. Finding and purchasing a health insurance plan through the marketplace may qualify you for subsidies—health insurance at a low or no cost—depending on your income.
To buy a policy through the marketplace, you must apply during open enrollment or special enrollment. Open enrollment for coverage begins Nov. To have your coverage start by Jan. Some state exchanges may have slightly different open enrollment periods.
If you miss open enrollment, you may qualify for a special enrollment period due to a major life change like moving, getting married, having a child or losing your existing health coverage. To begin your search for insurance through the marketplace, head to Healthcare. A health insurance broker or agent is a trained professional who can help you navigate the wide range of insurance options and enroll in the best health insurance plan for you. An agent may work for a single health insurance company while a broker will represent several companies at once.
You can also enter your phone number or email address to be contacted by an agent or broker to talk about plan choices. Agents and brokers must be licensed in their states to sell health insurance and are often required to act in the best interest of the customer. Some people may find plans that better fit their specific needs or budget by shopping directly with health insurance companies. These outside-of-marketplace plans exist only in a few limited cases and must still meet all minimum essential coverage requirements of the ACA.
Purchasing a plan outside of the marketplace removes the opportunity for premium tax credits or other subsidies that are available through the marketplace. These private enrollment websites come with a few caveats. Second, these private web brokers may display plans that pay them higher commissions first.
You can always check Healthcare. These health plans require membership to a professional, trade or membership organization. Customers shopping outside the marketplace should also be cautious of healthcare-sharing ministries, where individuals of a shared faith contribute money to a health care cost pool distributed by a ministry to pay for certain health-related expenses. If you have a qualifying event, in most cases, your coverage will take effect either the first of the next month, or the first of the month after that, depending on how late in the month you enroll.
Typically, if you enroll during the first 15 days of the month, your coverage will take effect on the first day of the next month. You can read more about the rules for each type of qualifying event here. This enrollment window allows low-income applicants to enroll year-round, without a need for a specific qualifying event. And plans purchased during open enrollment take effect January 1 or February 1, depending on when you enroll.
Curious about plans and rates in your state? Call to talk to a licensed agent about your coverage options. Even better, Medicaid enrollment is year-round. Federal poverty level calculator Gross income Weekly Annually Members in household 1 2 3 4 5 6 7 8 9 10 11 12 What state do you live in?
Alaska Hawaii All other 0. The good news is that if your application is successful, your Medicaid coverage will be effective either on the date of the application or the first day of the month that you apply. And in e ven better news for some applicants: Most states still have a three-month retroactive coverage period for Medicaid enrollees who would have otherwise been eligible in the months prior to their application.
States can seek federal approval to eliminate this retroactive coverage availability, and some did so under the Trump administration. This could be very beneficial if you received medical care in the days or weeks before you submitted your application.
This federal poverty level calculator will help you determine whether you meet the Medicaid eligibility level for your state. New York and Minnesota have Basic Health Programs the Essential Plan and MinnesotaCare , both of which offer year-round enrollment and are available to residents with income up to percent of the poverty level.
Massachusetts has a program called ConnectorCare , which is available to residents with income up to percent of the poverty level. And Connecticut created the Covered Connecticut program in People eligible for this coverage can enroll anytime until the end of Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.
Her state health marketplace updates are regularly cited by media who cover health reform and by other health insurance experts. We do not sell insurance products, but this form will connect you with partners of healthinsurance.
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