The time has arrived for Americans when they vigorously shop for health insurance, and during this open enrollment period, people seem to be more desperate to have health insurance, due to the growing threat of the Coronavirus. People here are well aware of the fact that going without health insurance means if they get sick or injured, then paying the bills for the received healthcare can cost a lot more than paying for the coverage. To help people easily shop for health insurance, the federal and state governments have set up a health insurance marketplace so that they can easily obtain coverage. The process of purchasing health insurance can be a bit confusing, so people may find the tips given below helpful while shopping for health insurance during this open enrollment period.
In some of the states, there is a law according to which individuals who do not have health coverage or who don’t have their kids covered may have to pay a fine each year. Thus, before shopping for a health insurance plan, individuals need to check if they or their children can get health coverage through some other way. Individuals will be assumed covered by the government if they have medicare, Medicaid, or a state-run child health insurance plan, or have coverage through their parents’ or spouses’ jobs. There is a possibility that children may already be covered or be eligible for free or low-cost coverage through a public program.
However, if individuals need to obtain health insurance for themselves or their children, then they can visit the government’s healthcare website to apply for CHIP, Medicaid, or shop for any other government plan. It is vital for people to remember that they can buy health insurance through the healthcare marketplace only during the open enrollment period. If they miss shopping for health insurance during the open enrollment period, then they will need to shop through a private health insurer to obtain coverage for that year. In some of the states, the healthcare exchange is run by Healthcare.gov, whereas some of the states run it themselves. Thus, individuals who live in those states that run it themselves, then need to visit their state’s official marketplace website directly.
Procedure to Apply for a Health Plan
People can apply for a health insurance plan through the health care marketplace or can be done online through Healthcare.gov or a state website, over the phone, or through regular mail by filling out a form. People first need to create an account on either healthcare.gov or their state’s marketplace before filling out an online application. Before filling an online application, people need to have following information about each person for whom they will be applying for the coverage.
- Social Security numbers
- Information about their incomes and employers
- Policy numbers of the plan, which they are currently having
If people are having an employer-sponsored health plan but they are not satisfied with the coverage, then they can get coverage through healthcare.gov. However, before applying people need to fill out a form called Employer Coverage Tool found on the healthcare.gov website.
People will need to provide standard information like their name, their child’s name, address, phone number, and email. People also need to provide information about their citizenship, dependents, and whether they plan to file a federal income tax return the following year or not. People if want help in paying for health insurance, then they will have to provide information about their yearly income along with the income of the individuals who will be covered under the plan. The annual income includes income from jobs and other sources like:
- Social Security
- Retirement accounts
- Property Rental
The Next Course-of-Action
On submitting their application, people will come to know whether they or their children qualify for Medicare, Medicaid, or CHIP. Healthcare.gov also determine whether individuals or their children are eligible to get insurance through the healthcare marketplace. Though it is not common, but sometimes parents are eligible to purchase health insurance through the health care marketplace but their children are not eligible. Sometimes kids are eligible but their parents are not eligible. People in both these cases have the right to appeal the decision, and they can still obtain a private individual plan for anyone who needs health coverage in their family. If people are eligible for health insurance coverage but don’t qualify for any publicly subsidized programs, then the marketplace will present them with the insurance plans available in their state based on their income and family situation. It will be up to the people to decide which plan to buy.
Things to Consider while Buying a Health Plan
The two most important things to remember while shopping for a health plan are premium and deductible. The health insurance premium is the amount that people pay every month to remain covered under a plan. The deductible is the amount that people need to pay each year for obtaining medical services before their health coverage kicks in. Generally, it is common that health insurance plans with low premiums have high deductibles and plans with high premiums have low deductibles. Some of the common health plan levels include:
Catastrophic Plan – Catastrophic health insurance plans are designed only for people under the age of 30 years and those who are unable to purchase other plans due to hardship. This plan is designed to protect a healthy person in case of a major injury or illness. The catastrophic plans have low premiums but very high deductibles and generally cover less than 60% of the healthcare costs.
Bronze Health Plans – Bronze health plans have low premiums and high deductibles but offer better coverage than catastrophic plans.
Silver Plans and Gold Plans – Both silver and gold health plans have average premiums and average deductibles. Silver plans cover 70% of the healthcare costs and Gold plans cover 80% of the healthcare costs.
Platinum Plans – Platinum plans come with high premiums and low deductibles and provide the highest level of coverage. These plans cover 90% or more of the healthcare costs.
All these levels of health plans offer free or discounted visits to the doctor for routine checkups, vaccinations, and some preventive care. Most of the health plans also offer discounts on prescription drugs and other services and there are some even some specific benefits that differ from plan to plan. People should make a decision regarding a health plan based on the fact that how well the plan meets their healthcare needs.
When the Health Plan will become Effective
Once the people sign up for a health plan and pay their first month’s premium, then they or their children become eligible to obtain health coverage. The health insurance carrier sends policy insurance cards to everyone covered under a plan. If the insured or their children need to see a doctor or visit hospitals before receiving the card, then they first need to call their insurance company to make sure that they and their family have been included in their system. People also need to ensure the doctor chosen by them is included in their insurance plan’s network. People should also try to know about their primary care physicians in their plan’s network and then choose a doctor of their choice. After selecting a doctor, people can schedule checkups and use their insurance to keep them and their families healthy.