Health Insurance FAQs
Frequently Asked Questions
When is the 2023 Open Enrollment Period?
The 2023 Open Enrollment Period for Health Insurance will take place from November 1st, 2022 through January 15th, 2023. Make sure you compare quotes and enroll while open enrollment is underway.
What is the Affordable Care Act (ACA)?
The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).
Is an ACA plan the same as Obamacare?
Yes, the Patient Protection and Affordable Care Act – is also commonly referred to and known as Obamacare.
Does everyone qualify for an ACA plan?
Not necessarily. The Affordable Care Act, also known as Obamacare, gives most uninsured people in the U.S. access to health insurance as long as they are U.S. citizens who live in the country, are not incarcerated, and are not covered by Medicare. Some may qualify for financial assistance or tax credits on the plan’s premium depending on your state and income.
What are the types of ACA plans?
Generally, ACA plans are organized into “metal tiers,” which determine how you and your plan split the cost of care. Bronze, Silver, Gold and Platinum.
What if I can not afford an ACA/Obamacare plan?
If you cannot afford Obamacare, see if you can qualify for the state-based insurance program called Medicaid. Your Obamacare application can help you determine if you qualify for Medicaid.
What are HMO and PPO plans?
There are two main types of individual and family health insurance or ACA plans. These include HMO and PPO plans. A PPO (Preferred Provider Organization) plan encourages you to use insurance company’s network of preferred doctors and hospitals, but will provide some out of network coverage. HMO plans (Health Maintenance Organization) usually provide members lower out-of-pocket health care expenses but they provide less physicians and hospital options.
Is pediatric dental coverage included in exchange plans?
Dental coverage is an essential health benefit for children. This means if you’re getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a stand-alone plan. Note: While dental coverage for children must be available to you, you don’t have to buy it.
Do all health insurance plans cover maternity care?
Nearly all plans cover maternity. Since January 2014, the ACA has required all newly issued and renewing individual and small group health insurance policies to provide maternity coverage.
How is vision care covered under the Affordable Care Act?
The Affordable Care Act requires coverage for pediatric vision care as one of the essential health benefits. They do not require insurers to provide routine vision care coverage for adults.
Are visits to the chiropractor or physical therapist covered under the Affordable Care Act?
All ACA-compliant individual and small group plans include coverage for physical therapy. Some individual market plans, sold via the health insurance marketplaces and off-exchange, include coverage for chiropractic services, but many do not. It depends in large part on where you live, as different states have different rules.
What is a Special Enrollment Period?
A Special Enrollment Period or SEP is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married or divorced, having a baby, adopting a child, or if your household income is below a certain amount.
What is the new Special Enrollment Period?
There’s a new Special Enrollment Period (SEP) available to lower income consumers allowing them to enroll in Marketplace coverage any time, if eligible. Consumers who qualify for this SEP may also qualify for more savings. Consumers who have an estimated annual household income at or below 150% Federal Poverty Level (FPL) in their state and aren’t eligible for Medicaid/CHIP may be eligible for this SEP. The annual household income at or below 150% Federal Poverty Level (FPL) varies by state and household size.
Find the 2021 FPL amounts used for 2022 Marketplace applications. This SEP is expected to affect millions of low income individuals and families.
Can I get 2022 Healthcare coverage outside of open enrollment?
How do I qualify for the special enrollment period?
What if I’m turned down for a Special Enrollment Period, but I think I qualify?
What is Medicaid?
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
What does Medicaid usually cover?
These services are provided by health plans. If you get Medicaid, you will choose a plan from the ones available in your service area.
What is CHIP?
CHIP, also known as Children’s Health Insurance Program, offers low-cost or free health coverage through Children’s Medicaid or the Children’s Health Insurance Program.
Children’s Medicaid is a health care program for children in low-income families. CHIP is a health care program for children without health insurance whose families earn too much to get Medicaid but cannot afford health insurance.
To get Medicaid or CHIP, a child must be age 18 and younger (in some cases children with disabilities age 19 and 20 can get Medicaid). They must also be a U.S. citizen or qualified non-citizen.
What services does CHIP cover?
Who’s paying for ACA’s Medicaid expansion? The federal government – or each state?
Can I use my Medicaid coverage in each state?
If my income is less than expected this year, I might be eligible for Medicaid. What can I do to cover my bases?
Income volatility and its impact on eligibility has already been addressed by various provisions of the ACA and IRS regulations. As of 2021, the rules have become more consumer-friendly for people who would otherwise be caught in the coverage gap in states that have not expanded Medicaid yet.
What is the Medicaid ‘coverage gap’ and who does it affect?
Customers with income below the poverty level are not eligible for the Affordable Care Act’s premium tax credits. If they’re in a state that has refused to expand Medicaid eligibility under the ACA, they may not be eligible for Medicaid either.
If I qualify for Medicaid, should I worry about the deadline for open enrollment?
What is Medicare?
Medicare is a health insurance program provided by the federal government for qualifying individuals, including people age 65 and older, those with certain disabilities, and individuals with end-stage renal disease (ESRD).
What are the Parts of Medicare?
When can I enroll in a Medicare plan?
Medicare’s Annual Enrollment Period (AEP) is every year from October 15th – December 7th. The Initial Enrollment Period (IEP) for Medicare is a seven-month period beginning three months before you turn 65, the month in which you turn 65, and three months after you turn 65. For example, if you turn 65 on June 14, your IEP is from March 1 through September 30.
What is Medicare Advantage?
Medicare Advantage is Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D. Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.
What is Originial Medicare?
Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you get them. When you get services, you’ll pay a deductible at the start of each year, and you usually pay 20% of the cost of the Medicare-approved service, called coinsurance. If you want drug coverage, you can add a separate drug plan (Part D).
What is a Medicare Supplement plan?
A Medicare Supplement plan, commonly known as Medigap, is an additional coverage option to Original Medicare. Medicare Part A and Part B only covers 80 percent of services. Adding a Medigap plan covers the remaining 20 percent, limiting coinsurance or co-payments as well as some additional out-of-pocket costs.
How do I qualify for a premium-free Medicare Part A at age 65 or older?
My parents are 68, but recently moved to the U.S. Do they qualify for Medicare or can they buy insurance in the exchange?
No they do not qualify for Medicare. But since your parents are not eligible for Medicare, they can purchase a private plan in the exchange and can receive cost-sharing reductions and premium subsidies if they are eligible based on income.
I am on Medicare and Social Security. My wife is self-employed and needs insurance from the state exchange. How do we figure out household income?
What is life insurance and why do I need it?
What kinds of life insurance can I get at work?
What are the advantages of purchasing life insurance through work?
How much life insurance do I need?
You should be able to develop a life insurance plan that, following your death, will allow your family to live comfortably without your economic contribution. Also consider the effect of inflation over time. The amount needed for retirement or college 20 years from now is likely to be significantly higher than today.
How many years should I choose for my policy?
The period of time you’ll need coverage for should be the main factor. If you have young children, you may want to consider 20 or 30 years of term life coverage to help your children for college or other future financial endeavors. On the other hand, if your children are out of college and supporting themselves, a shorter coverage period might suit your needs better.
How much does life insurance cost?
How can life insurance be more affordable?
Buy it now. Premiums for the same coverage generally increase the older you become. The longer you wait, the more you risk developing a health condition that could increase your premium further, or make you uninsurable.
Are there tax advantages with life insurance?
Death benefits are generally received income tax-free by your beneficiaries. In the case of permanent life insurance policies, cash values accumulate on an income tax-deferred basis. That means you would not have to pay income tax on any of the policy’s earnings as long as the policy remains in effect.
What if I already have life insurance?
What is a beneficiary and why is it important to designate one?
Why should I choose a reputable insurance company?
How Do I Get Travel Insurance Quotes?
Getting travel insurance quotes with Healthedly Insurance Services is easy. Visit our page and we will help you find the right travel insurance meant for you.
What Should I Enter in the Quote Form for “Cost of Your Trip?” and/or “Trip Cost”?
Enter the total amount of your non-refundable and pre-paid travel arrangements to be insured. If you would like to see plans that exclude trip cancellation coverage, then enter $0 for your Trip Cost. Frequent flier miles and their dollar equivalents cannot be insured.
What Should I Select as “Your Primary Destination?” in the Quote Form if I Am Visiting Multiple Countries?
Select your destination country from the list. If you are visiting multiple countries, choose the destination where you will be spending the most time during your trip or one of the countries. If you are spending equal time in each, you will still be covered when visiting other countries from your specified departure date through your return date.
How Do I Enter My Departure and Return Dates in the Quote Form?
Click on the calendar icon to select the date that you are leaving for your trip as well as the date that you return.
What Should I Choose in the “How Many Travelers?” Section of the Quote Form?
Select the number of travelers that you would like to insure on this policy. Only add travelers that share the same trip dates/itineraries. Quote and buy separately if you have travelers with differing itineraries and/or states of residence.
What Should I Enter in the “Current Age of Travelers (as of Today)?” Section of the Quote Form?
Enter the age of each traveler with one traveler’s age per box. Make sure not to enter the age of the person during the trip dates. Enter the age of additional travelers in separate boxes. If a child is under one year old, enter 1.
What Should I Enter in the “Date of First Trip Payment?” and/or “Trip Deposit Date” Section of the Quote Form?
Select the initial date that you made a partial or whole payment for your trip. If you booked with rewards points and no actual payment, use the date that you booked your trip. If you have not purchased your travel yet, select today’s date to see quotes.
What is a Group Health Insurance Plan?
What’s the Difference Between Group Health Insurance and Individual Coverage?
Does a Group Health Plan include Dental or Vision Coverage?
Why is Group Health Insurance More Expensive than Individual Plans?
How Does a Business Qualify for Group Health Insurance?
Which Employees are Eligible for Group Health Coverage?
How Do You Apply For Group Health Insurance Cover?