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Everything You Need to Know About Special Enrollment Periods (SEP)

General
Everything You Need to Know About Special Enrollment Periods (SEP)

Special enrollment periods (SEP) are a crucial aspect of the health insurance landscape, allowing individuals to enroll in a health plan outside of the regular open enrollment period. 

These periods are designed to provide consumers with greater flexibility and help them secure coverage when they need it most. Here is everything you need to know about special enrollment periods.

What is a special enrollment period?

A special enrollment period (SEP) is a time frame during which individuals can enroll in a health plan outside of the regular open enrollment period. These periods are typically triggered by certain life events, such as losing health coverage, getting married, or having a baby.

When can you enroll during a special enrollment period?

SEP’s are typically available for a limited time after a qualifying life event, such as 60 days after losing health coverage. It is important to note that the length of time for the SEP may vary depending on the event.

What are the qualifying life events for a special enrollment period?

The most common qualifying life events that trigger a special enrollment period include:

  • Losing health coverage
  • Getting married
  • Having a baby
  • Adopting a child
  • Gaining citizenship or legal status
  • Moving to a new area
  • Leaving prison

It’s important to note that not all events qualify for a special enrollment period.

Where can you enroll during a special enrollment period?

During a special enrollment period, individuals can enroll in a health plan through the Health Insurance Marketplace or directly through an insurance company. In some states, Medicaid and the Children’s Health Insurance Program (CHIP) also have special enrollment periods.

What happens if you miss the special enrollment period?

If you miss the special enrollment period, you will have to wait until the next open enrollment period to enroll in a health plan. Additionally, if you don’t have health coverage, you may have to pay a penalty when you file your taxes.

How to enroll during a special enrollment period?

To enroll in a health plan during a special enrollment period, you will need to provide documentation of your qualifying life event. This documentation may include marriage certificates, birth certificates, or documentation of a loss of coverage. You can enroll in a health plan through the Health Insurance Marketplace or directly through an insurance company.

It’s important to be aware of special enrollment periods and how they can affect your health coverage. If you experience a qualifying life event, be sure to take advantage of a special enrollment period to secure coverage. 

Don’t hesitate to reach out to a Healthedly health insurance agent or broker for help understanding your options and enrolling in a plan during this period.

Are you looking for a health insurance plan that is customized to your needs? Healthedly agents await your call and your questions. Give us a call at 855-522-2201!

January 30, 2023
https://healthedly.com/wp-content/uploads/2023/01/Healthedly-Blog-1-1030x679-1.png 679 1030 Rebecca Allen https://healthedly.com/wp-content/uploads/2022/06/Healthedly.svg Rebecca Allen2023-01-30 12:52:372023-03-06 13:55:35Everything You Need to Know About Special Enrollment Periods (SEP)

How Much Is Health Insurance in Florida? Here’s What You Need to Know

Health
Happy healthy young girl with father giving female doctor a high five

Health insurance protects you and your loved ones should you need medical care. Below, we explore how much health insurance is in Florida, and how you can keep the costs down.

What Is Health Insurance?

Health insurance is an agreement between you and an insurance company. With a health insurance policy, the insurer agrees to pay all (or some) of your medical expenses if you fall ill or need medical care. In exchange for cover, you pay monthly premiums.

Without health insurance, you could struggle to pay for medical treatment.

What Is the Cost of Health Insurance in Florida?

There’s no single cost of health insurance in Florida. Health insurance costs vary depending on, for example, your ZIP code, medical history, and copays.

  • You can find basic health insurance cover in Florida starting from around $200 per month. Basic packages cover you for medical emergencies but they may not be suitable if you have more complex needs.
  • On average, you could pay around $467 per month for a health plan in Florida.
  • It costs, on average, $7,389 a year per person for health insurance in Florida.

These figures are only estimates; you should shop around for quotes to find the best plan for you.

Is Health Insurance Expensive in Florida?

Florida health insurance costs can be high. However, according to research, the baseline costs are in line with what Americans pay across the US.

There’s one exception, and that’s employee health insurance. In Florida, workers pay among the highest premiums in the country. Relatively speaking, health insurance does work out fairly expensive in Florida.

How Can I Reduce the Cost of Health Insurance in Florida?

If you’re looking to control the cost of your health insurance, here are some tips.

  • Increase your deductible (the amount you pay for treatment before your insurance kicks in). Higher deductibles usually mean lower monthly payments because you’re paying more for treatment out of your own pocket.
  • Explore whether it’s cheaper to insure your family on the one plan with a single renewal date rather than having different family members on their own separate plans.
  • Review your policy before agreeing to medical treatment. There may be cheaper alternatives available to you, depending on your level of cover.

Always contact professional insurance agents for advice. Our team understands the marketplace and we know how to source the best quotes for our customers.

Learn More About Florida Health Insurance Costs

The cost of health insurance Florida largely depends on the level of cover you need and how many people are covered by your policy. At Healthedly, our team will work with you to determine the cover you need and we can help you explore the plans available. Whether you’re looking for a new policy after moving out of state, or you wish to enroll in a new plan, we can support you.

Check out the Florida health insurance plans available to residents now!

January 23, 2023
https://healthedly.com/wp-content/uploads/2023/01/Healthedly-Blog-1-1030x679-1.png 679 1030 NP Accel https://healthedly.com/wp-content/uploads/2022/06/Healthedly.svg NP Accel2023-01-23 17:07:392023-01-23 17:08:20How Much Is Health Insurance in Florida? Here’s What You Need to Know

Do I Need Health Insurance if I Have VA Benefits?

Medicare
Cropped picture army person completing a form in background with stethoscope and paperwork on white table

“If I have VA benefits, do I need health insurance?” If you’ve ever asked yourself this question, you’re not alone. Trying to compare between VA benefits and health insurance can be confusing, so here’s a look at how VA benefits work and why you might still need health insurance.

Do US Veterans Get Free Health Care?

As a US veteran, you qualify for free VA health care if you develop a “service-connected” injury or illness. A service-connected injury or illness is any ailment caused by or related to your military service. You may also qualify for free health care if you:

  • fall below certain income thresholds; or 
  • are severely disabled i.e. you have a disability rating of at least 50%. 

Healthedly can help with your VA health care needs – contact us to learn more. 

What Are VA Health Insurance Benefits?

VA health care covers a variety of health services at VA hospitals, clinics, and outpatient centers. Benefits include:

  • counseling
  • emergency care 
  • hospice care
  • inpatient treatment e.g. surgery
  • medication  
  • outpatient treatment e.g. physiotherapy
  • prosthetics and orthotics

If you have VA benefits, you will be treated at a VA medical center. In emergencies, you may be treated elsewhere and moved to a VA center once stabilized. 

VA Health Insurance Benefits Eligibility

Individuals can qualify for VA health insurance benefits if they:

  • have served active duty in the air, naval, or military service; and 
  • were not dishonorably discharged. 

Members of the National Guard or Reserves do not qualify unless they have served a full active duty period.   

Do VA Benefits Count as Health Insurance?

Yes. Anyone enrolled in VA benefits is considered to have sufficient health insurance under US law. So, if you’re enrolled in any one of the following programs, you don’t need extra coverage:

  • Spina bifida health care benefits program
  • TRICARE
  • VA Civilian Health and Medical Program
  • Veterans health care 

Do I Need Supplemental Health Insurance With VA Benefits?

Maybe – just because VA benefits count as health insurance doesn’t mean they’re enough to offer complete protection. Here’s why. 

When you sign up for VA benefits, you’re assigned to a priority group between one and eight. Group one veterans have significant injuries, can’t work due to their condition, or have received a Medal of Honor. They receive comprehensive, free health care through their VA benefits. 

On the other hand, if you’re assigned to a lower priority group, such as group eight, you’ll be expected to cover the costs of injuries or illnesses unless they’re service-related. You could be left unable to meet the costs of medical treatment without supplementary insurance in place.

Bottom line? Although VA benefits count as health insurance, they might not offer the fullest coverage. Healthedly can help you find, compare, and enroll in the best available individual and family health plans. Call us now to learn more.

January 15, 2023
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How to Change Health Insurance

Health, Life Insurance
Man and woman discussing changing health insurance with agent looking at papers

If your health insurance is no longer working for you, it’s simple enough to change plans – here’s how it works.

When Can I Change My Health Insurance?

You can enroll in Medicaid at any time. Otherwise, you can switch during the Open Enrollment Period or the Special Enrollment Period.

  • Open Enrollment Period: You can change your health insurance during the annual Open Enrollment Period. The dates vary slightly depending on the plan, but Open Enrollment normally takes place between October and January each year.
  • Special Enrollment Period: Certain life events, such as moving state, having a baby, or getting married, trigger a Special Enrollment Period during which you can change policies.

Some job-based plans have slightly different enrollment plans, so always check with your employer if you’re unsure.

How Long Does it Take to Change Health Insurance?

Here’s the good news: changing health insurance is quick and easy, and it’s even faster with our help. It only takes a few minutes to complete our form or call our agents, and we’ll help you select and sign up for health insurance as quickly as possible if you’re eligible.

How to Change Health Insurance

Changing health insurance providers or switching plans is simple. 

  • When the Open Enrollment Period comes around, review your existing policy. Consider what changes you need to make so you know what coverage you’re looking for.
  • Think about how much you can afford to pay each month and bear this in mind when shopping around.
  • Compare quotes online or let our friendly team help you choose and enroll in a new plan.

If you’re in a Special Enrollment Period, you may need to provide proof of this before getting insurance. 

Canceling Your Health Insurance

You can normally terminate your health insurance plan whenever it suits you (unless your employer places restrictions on this). To end the plan, just call the insurer and advise them of your wish to cancel. You can choose a date for coverage to end or you can end the plan immediately.  

How to Change Health Insurance When Moving Out of State

Some health insurance policies expire when you cross state lines, or they might not offer you the same level of cover. If this happens to you, it’s simple to switch policies.

  • Moving to a new state is a qualifying event which triggers a Special Enrollment Period. So, you can easily change plans or coverage at any time of year to suit your new circumstances. 
  • Shop around for a new insurance plan which meets your needs, and apply within 60 days of moving. Otherwise, you may not qualify for the Special Enrollment Period any longer.  
  • Your new coverage probably won’t start right away. To cover the gap, consider taking out short-term health insurance. These plans take effect from the day you apply so you’ll be covered immediately.

At Healthedly, we can help you find, compare, and enroll in the best available individual and family health plans. To learn more about how to cancel your health insurance, or to switch plans, contact us now.

January 13, 2023
https://healthedly.com/wp-content/uploads/2022/09/Healthedly-Blog-1.png 900 1366 Rebecca Allen https://healthedly.com/wp-content/uploads/2022/06/Healthedly.svg Rebecca Allen2023-01-13 06:14:042023-01-31 12:23:50How to Change Health Insurance

When Is Open Enrollment for Health Insurance?

Health, Health Resources
Child and adult hands cupping a small red heart for family health

When you’re choosing health insurance, it’s important to know when (and how) you can change plans. Normally, you can enroll in health insurance or switch plans during the Open Enrollment Period (OEP). But when is Open Enrollment, and how does Open Enrollment work? We consider these questions below. 

What Is Open Enrollment?

OEP is the one time of year when most Americans can choose health insurance, whether it’s enrolling in a new plan or switching to a different policy. 

What is the point of Open Enrollment, though? It’s simple – the OEP gives people a chance each year to enroll in a policy that best reflects their changing health needs. Without an OEP, many people would have insufficient coverage in place and no way to change it. 

When Is Open Enrollment 2023?

Helpfully, the dates stay roughly the same each year. 

In most states, the OEP for 2023 started on November 1, 2022. If you want your plan to start on January 1, 2023, you have until December 15, 2022 to change plans or enroll in a new one. Once you enroll or change plans (and pay your first monthly premium), your cover starts.

If you missed the initial deadline, you have options. You have until January 15, 2023 to enroll or change policies for this coming year. Once you pay the premium, cover starts from February 1, 2023. 

It’s not too late to qualify for Open Enrollment in 2023. Contact us for quotes or if you need help choosing a health insurance plan. 

Annual Open Enrollment for Medicare

If you’re on Medicare, they have their own annual Open Enrollment Period (usually between October and December, or January through March if you have Medicare Advantage). 

Unsure which deadline applies? Call our team for advice. 

Can I Apply Outside of the Open Enrollment Period?

Yes, but only if you qualify for what’s called a “Special Enrollment Period” (SEP). 

Special Enrollment Periods take into consideration how your life can change over the course of the year between Open Enrollment Periods. Just as your life changes more than once a year, so should you be able to switch health policies quickly to better suit your needs.

What triggers a SEP? You qualify if you experience a significant life event (“qualifying” event) such as:

  • getting married or divorced
  • moving to a new state
  • turning 26

If you’re not eligible for a Special Enrollment Period, you may need to wait for Open Enrollment to come around again before you can get health insurance.  

How Do I Get Ready for Open Enrollment? 

Although Open Enrollment can be confusing, here’s what you can do to prepare. 

  • Think about your healthcare needs. Does your existing health insurance give you enough protection, or do you need a more comprehensive policy?
  • Set a budget for how much you can afford to spend each month on health insurance premiums. 
  • Shop around for a competitive quote – don’t rush. Our team can answer any questions you have if you need extra support. 

Looking for health insurance? Healthedly can help you find, compare, and enroll in the best available individual and family health plans – call on (855) 522-2201.

January 11, 2023
https://healthedly.com/wp-content/uploads/2022/09/Healthedly-Blog-1.png 900 1366 Rebecca Allen https://healthedly.com/wp-content/uploads/2022/06/Healthedly.svg Rebecca Allen2023-01-11 02:29:002023-02-17 17:40:52When Is Open Enrollment for Health Insurance?

What Happens if I Don’t Have Health Insurance?

Health, Health Resources
Three sets of adult and children hands holding a red heart with white heart rate line along it

“I don’t have health insurance.” If you don’t have coverage, you might be worried about the future. What happens if you need medical care, and can you be penalized for being uninsured? We consider these points and more below. 

How Many Americans Don’t Have Health Insurance?

Worryingly, over 9% of Americans are uninsured, according to the latest data from the National Center for Health Statistics. This works out at just over 31 million people – a staggering number of individuals who don’t have enough insurance to cover their medical expenses. Other key findings include: 

  • 3.7 million of children under 5 are uninsured.
  • 31.2 million people under 65 don’t have health insurance. 
  • 27.5 million Americans aged between 18 and 64 aren’t insured.   

Are You Legally Required to Have Health Insurance?

No – there’s no legal requirement at the federal level to have health insurance. However, some individual states still require you to have health insurance. You must have coverage if you live in:

  • California
  • District of Columbia 
  • Massachusetts
  • New Jersey
  • Rhode Island 
  • Vermont

Are You Penalized if You Don’t Have Health Insurance?

There’s no tax penalty at the federal level. However, if you’re in a state where health insurance is mandated, then you could face tax penalties if you don’t have coverage. 

The penalties vary by state. In California, for example, you’ll pay:

  • At least $425 for each uninsured child under 18 
  • At least $850 for each uninsured adult in the household  

If you need an exemption, you might be able to claim one when you file your tax return, or follow your state’s specific guidelines.   

If You Don’t Have Health Insurance, What Happens?

If you don’t have health insurance, a few things can happen. 

  • If it’s a medical emergency, doctors must treat you. However, once you are stable, they don’t have to provide treatment unless you’re insured – or you can prove how you will cover the costs. 
  • You will be expected to cover the full costs of treatment including prescription medicines, medical devices, and related care. 
  • It will be your responsibility to pay for procedures you might need for your health and wellbeing. 

While health insurance may not pay for every fee, it certainly helps to cover the costs.  

Do I Need Health Insurance?

You need health insurance if it’s mandated in your state. Otherwise, it’s a personal choice, but here’s why it might be worth it. 

  • Without health insurance, you’re responsible for all of your own medical bills. This could make healthcare unaffordable for many people.  
  • You may find yourself in debt trying to cover the costs of medical care. This could have serious consequences for your financial health e.g. your credit score. 
  • Health insurance gives you peace of mind, knowing that your health needs are covered. You can focus on getting better rather than stressing over money. 

Need health insurance? Contact Healthedly. We can help you find, compare, and enroll in the best available individual and family health plans – reach out today.

January 10, 2023
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What Is Considered a Qualifying Event for Health Insurance?

Health, Health Resources
Young man and young woman studying a health insurance document

“Qualifying event” is a term we hear a lot, but it’s not always clear what it means. Below, we explain how qualifying events for health insurance work and how they affect you.  

What Is a Health Insurance “Qualifying Event”?

A qualifying event is a change in your life circumstances. Not every life event is a “qualifying” event, though – it must be a change which is significant enough to possibly affect your health insurance coverage. For example, maybe you’re adding new family members, moving to a new state, or switching jobs. We’ll go over what counts as a health insurance qualifying event below. 

What Happens During a Health Insurance Qualifying Event?

A qualifying event triggers what’s called a Special Enrollment Period (SEP). The SEP is a period of time during which you can choose a new plan outside of the annual Open Enrollment Period (OEP). 

If this is your first time taking out health insurance (for example, you’re about to turn 26), the SEP is an important step in taking charge of your own affairs. And even if you already have health insurance, an SEP is your chance to shop around for a new plan which may serve your needs better.   

How Long Do I Have to Act?

It depends on the type of qualifying event. You may have up to 60 days before the event, and/or up to 60 days after the event to enroll in a health plan.

For example, if you’re about to lose coverage due to turning 26, your enrollment period begins 60 days before the event, and ends 60 days after your birthday. And if you’re getting married, you have up to 60 days after the big day to choose a plan.   

Qualifying Life Events for Health Insurance

While this is not an exhaustive list, here’s a breakdown of the most common health insurance qualifying events. 

Change in Life Circumstances

Major life events trigger Special Enrollment Periods. Major events include births, adoption, deaths, marriage, and divorce. 

Loss of Health Insurance

If you lose health insurance, whether it’s because you turn 26, lose job-based coverage, or your eligibility changes, this qualifies you for a Special Enrollment Period. 

Residence Changes

If you’re moving to a different state (or even changing county or ZIP code), this is a qualifying event. It’s also a qualifying event if you’re a student moving to a new place for school, or you’re leaving sheltered housing. 

Other Qualifying Events

Other events which might trigger SEPs include becoming a US citizen, leaving prison or jail, or experiencing significant income changes.  

What Documents Do I Need to Prove a Qualifying Event?

It all comes down to what triggers the Special Enrollment Period. The documents you might need include:

  • birth certificates
  • death certificates
  • divorce papers
  • marriage papers
  • rental agreement

At Healthedly, we can help you find, compare, and enroll in the best available individual and family health plans. Contact us now.

January 8, 2023
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What do Americans think of the current U.S. healthcare system?

General, Health, Individual and Family
What do Americans think of the current U.S. healthcare system?

There is a wide range of opinions on the current U.S. healthcare system. Some people believe that the health system in the U.S. is the best in the world. After all, our health system provides high-quality care to those who can afford it. However, others believe that the healthcare system is in need of significant reform. It is too expensive, complex, and unfair. Surveys have consistently shown that the cost of healthcare is a major concern for many Americans. A significant percentage of the population supports the idea of universal healthcare, where a single-payer system covers everyone. While many people oppose the idea of universal healthcare, most believe it would be too expensive. Meanwhile, others value the freedom to choose their own providers and plans.

There are a number of reasons why some Americans do not prefer the current U.S. healthcare system.

Some common concerns include:

High cost:

The cost of healthcare in the U.S. often gets cited as a major problem. Many Americans struggle to afford the high cost of insurance premiums, deductibles, and copays. Due to this, folks may be unable to access the care they need because of the cost.

Lack of access to healthcare:

Despite being the world’s wealthiest country, the U.S. has a high rate of uninsured citizens. Hence, many people still cannot enjoy access to affordable healthcare.

Complexity:

The U.S. healthcare system often gets criticized for its excessive complexity. The wide range of insurance plans, providers, and regulations that can be difficult for people to navigate.

Limited choices:

In some parts of the U.S., there may be a limited number of providers or insurance plans available. This can limit people’s options and make it difficult to find the care they need.

Shortage of primary care doctors:

Another concern? There is a shortage of primary care doctors in the U.S., which can make it difficult for people to access routine health services.

High administrative costs:

Last but not least, the U.S. health system struggles chronically with having high administrative costs. Unfortunately, this tends to drive up the overall cost of medical care.

Lack of transparency:

Some people may feel that the health system is not transparent enough, with prices for procedures and treatments often being unclear or hard to obtain.

Are you looking for more affordable health insurance? Healthedly’s mission is to connect people with an affordable health insurance plan. Whether you are an individual or a family, our agents will do everything possible to ensure you are set up with health coverage, regardless of income or employment.

Get started today with Healthedly, chat with an agent, we will send you a free quote for a health insurance plan that works for you!

January 3, 2023
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