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The importance of affordable coverage for you and your family:

Obtaining affordable healthcare is something that should be very important to you and your family.  Sickness or injury is never planned.  But once it happens, it’s essential to have access to proper medical attention and the costs can be very expensive without health insurance coverage.

Having affordable health insurance helps protects you from these high medical costs just through the cost -sharing with your insurer.  Using covered in-network healthcare providers will also help with the savings, even before your deductible is met.  Another important thing to remember is the free preventative care you can take advantage of to help such as vaccinations and screenings, also before your deductible is met.  As long as you have qualifying coverage, you won’t be subject to the fee, which also will help in your cost savings.

When we talk about how affordable health coverage protects us financially from unexpected and expensive medical costs, this is accomplished in 3 main ways.

  • After your deductible – When you’ve reach your deductible on spending for your covered medical services, your plan will then start to share in the expenses past that.  Depending on your chosen coverage, Marketplace plans will cover anywhere from 60% to 90% of those costs after the deductible is met
  • Eliminates yearly/lifetime limits – Marketplace plans will not place a financial limit on the amount they will spend to cover your essential health benefits within a year or a lifetime.
  • Out-of-pocket max – An out-of-pocket maximum sets a limit on how much you will pay in medical expenses no matter how much covered care you receive within the plan year.

Another benefit of having affordable health coverage is that you can also find savings before you ever meet your deductible.  Oftentimes, health insurance companies negotiate special rates with providers so that they can attain discounted rates for medical services.  This benefit is passed down to their enrollees when they use these providers’ services.  So before ever meeting the deductible, you will benefit in savings when you use a provider within your plans network.  Not all Marketplace plans will offer network discounts.  Some plans don’t have networks at all.  But many do.

A big way that health insurance coverage will save you money is through free preventative care to take advantage of.  Preventative services such as screenings, immunizations, contraception, etc. are covered by all Marketplace plans even before your deductible is met when using network providers.  Other services such prescription drugs or doctor appointments may be covered, depending on your plan.

Why you should be looking at providers who provide minimal essential coverage at an affordable cost:

All Marketplace plans offer the same basic set of minimum essential health benefits that must be covered.  These services will generally all have deductibles, co-payments, and other out-of-pocket expenses and may differ from category of plans from bronze, silver, gold, and platinum.  Below is a list of some of these covered services and items:

  • Emergency services
  • Hospitalization
  • Ambulatory services
  • Prescription drugs
  • Mental health/Substance disorder services
  • Laboratory services
  • Preventative care
  • Rehabilitative services and devices
  • Habilitation services and devices

It’s important to remember that although these essential health benefits are covered in all Marketplace plans, they are not required to be offered in grandfathered plans or “self-insured” plans that many large employers may offer.

Need 2016 HealthCare Coverage? There is still time to qualify!

Why is it important to have access to resources providing new healthcare requirements to avoid penalties for you and your family:

Prior to the Affordable Healthcare Act legislation, understanding, comparing, and choosing different health care coverage was not always a very simple task.  One of the ACA’s biggest objectives was to help reform and simplify the process and make it more accessible for more Americans to resources and obtaining quality, affordable insurance coverage.

Since the implementation of the ACA there have been many new changes made in the healthcare system.  Several commonsense regulations have been put in place to benefit the general public and help reform the system.  Failure to abide by these changes carries a penalty.  So it is very important to have access to clear concise information on the benefits of health coverage, and the penalties for failure to obtaining it.

  • Online – You are now able to gain access to this information, apply, and enroll in many ways.  Online access includes healthcare.gov as well as many other informational websites designed strictly for educating and assisting the public with the new healthcare system.
  • If you prefer to apply and enroll in person, or need guidance in the processes, you can locate an assister who will sit with you and help you in this process.  Along with helping you with the whole application and enrollment processes, they can answer any questions and work with you in choosing a plan that best fits your needs. Visit HealthCare.gov to locate an assister near you
  • Over the phone – If you choose, you can bypass the mailing option by completing your application and enrollment over the phone with a Marketplace Call Center Representative at 1-877-637-0040.  Phone lines are open 24 hours, 7 days a week.

How much easier is it now to find the best coverage for you and your family:

The Health Insurance Marketplace has put in much effort and focus to make enrollment easy and accessible for all people than it was before.  There is now uniform coverage documents developed to make it much easier to compare plans to one another when shopping for health insurance.  This new standardized document now helps to allow you to make a better informed decision for plan that’s right for you and your family.

Another major area of focus to make finding coverage much simpler is the establishment of Healthcare.gov as an internet portal to assist you in providing accurate information, choosing a plan for you and your family, and the whole application/enrollment process.

In terms of simplifying the application and enrollment process for all Americans, there are 4 ways in which you and your family can apply for coverage through the Marketplace are as follows:

  • Apply online- To apply online, you will be asked to set up an account.  You can visit the Get Coverage page and start out by selecting your state and clicking the “Apply Now” link.  Once you do this, you will be prompted to provide some basic information and set up a secure account.
    • You will then be directed to fill out an application.  The application process will require you to provide certain information regarding your income, current health coverage, household member information, etc.
    • Once the application process is completed, you will be able to view your eligibility results and all the options for coverage that you and your family are qualified for.  You will also be able to determine if you are eligible for other savings, including the premium tax credits.  You may also know if you qualify for Medicaid or CHIP coverage.
    • Once you review your results, you will now be prompted to enroll in the plan that you choose.  You will be provided your new insurance company contact information so you can finish enrollment and make your first payment
  • Apply by mail – You can send in your application by mail by filling out a paper application.  As soon as you get your eligibility results, you can finish the enrollment process either online, or over the phone through the Marketplace Contact Center at 1-877-637-0040.
  • Apply over the phone – If you choose, you can bypass the mailing option by completing your application and enrollment over the phone with a Marketplace Call Center Representative at 1-877-637-0040.  Phone lines are open 24 hours, 7 days a week.
  • Apply in person – If you prefer to apply and enroll in person, or need guidance in the processes, you can locate an assister who will sit with you and help you in this process.  Along with helping you with the whole application and enrollment processes, they can answer any questions and work with you in choosing a plan that best fits your needs. Visit HealthCare.gov to locate an assister near you