How to Shop for Health Insurance (for Parents) – Nemours KidsHealth
Note: Some parts of the Affordable Care Act (“Obamacare”) are being changed or eliminated through government laws and policies. Some of the rules and regulations that affect the health insurance market are likely to continue to change over time. To stay up to date on obamacare and other health insurance topics, visit healthcare.gov and your state health commissioner’s office website.
Today in America, we all need health insurance. you do. your kids do. It’s no longer a “nice to have”, it’s a “must have”. and that is the law. In most cases, parents who aren’t covered (or don’t have their children covered) by health insurance may have to pay a penalty each year. being without it also means that if someone gets sick or injured, a family may have to foot all the bills for care received. that can cost much more than paying for coverage.
To help people get health insurance, the federal and state governments established a health insurance marketplace (also called a health care exchange). this makes it easier than ever to get coverage, but the process can seem a bit confusing.
Here’s what you need to do to get health insurance.
Before you shop for a health insurance plan, check to see if you or your child can get coverage some other way. The government considers a person to be covered if they have Medicare, Medicaid, a state-run children’s health insurance plan (CHIP), or insurance they get through the work of a parent or spouse. your child may already be covered or eligible for free or low-cost coverage through a public program.
If you need to get insurance for yourself or your child, you can go online and visit the us. uu. government comprehensive health care website (www.healthcare.gov). there, you can apply for chip or medicaid or buy a plan.
However, it’s important to remember that you can only buy insurance through the health care marketplace during the open enrollment period, which starts in mid-November and runs through February. If the enrollment period has ended, you or your child may need to get insurance through a private insurer to be covered that year.
In some states, the health care exchange is run by healthcare.gov. other states run it themselves. If you live in one of those states, you can visit your state’s official Marketplace website directly or link to it through healthcare.gov.
if you don’t have regular access to a computer, you can call the us. uu. Government Helpline at 1-800-318-2596 to complete an application, enroll, or compare plans.
how to request a plan
applying for an insurance plan through the health care marketplace can be done online through healthcare.gov or a state site, by phone, or by regular mail by completing a form that can be mailed to you or Internet download. .
Before you complete an online application, you’ll need to create an account at healthcare.gov or your state’s marketplace.
You will 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)
- employer and income information
- policy numbers for any current health insurance plans
- social security
- retirement accounts
- property rental
- catastrophic insurance is designed to protect a healthy person in the event of a major injury or illness. It is available only to people under the age of 30 and those who are exempt from other plans due to financial hardship. This type of insurance can have low premiums but very high deductibles. plans typically cover less than 60% of health care costs.
- Bronze plans also have low premiums and high deductibles, but offer better coverage than catastrophic insurance, typically paying 60% of costs.
- silver plans and gold plans have average size premiums and deductibles. silver plans cover 70% of costs. gold plans pay 80% of costs.
- platinum plans, the highest level of coverage, have high premiums and low deductibles. these plans cover 90% or more of health care costs.
If you have a job that offers health insurance but you’re not happy with it, you can choose to get coverage through healthcare.gov. But before you apply, you’ll need to fill out a form called an Employer Coverage Tool that can be found on the healthcare.gov website.
The app will ask for standard information such as your name, your child’s name, your address, phone number, and email. You’ll need to answer questions about citizenship, dependents, and whether you plan to file a federal income tax return next year.
If you want help paying for insurance, you’ll need to provide information about your annual income (and the income of anyone else applying for coverage). this includes income from jobs and other sources such as:
If you pay alimony or student loan interest, you can deduct the amount you pay when you apply.
what happens next?
once you’ve submitted an application, healthcare.gov or your state’s site will determine if you or your children qualify for medicare, medicaid or chip. It will also determine if you or your children are eligible for insurance through the health care marketplace. For most people, if you’re a US citizen or legal immigrant and not in jail, you’ll be eligible.
Although unlikely, sometimes parents are eligible to purchase insurance through the health care marketplace, but their children are not. sometimes children are eligible but their parents are not. If any of these apply to you, you would have the right to appeal the decision and still be able to get private insurance for anyone who needs coverage.
If you’re eligible for coverage but don’t qualify for any publicly subsidized programs, the Health Care Marketplace will present you with the insurance plans available in your state based on your income and family situation. It will be you who decides which policy to buy.
what to look for when choosing a policy
The important words to remember when buying a policy are “premium” and “deductible.” The premium is the amount you pay each month for coverage. The deductible is the amount you must pay each year for medical services before your health insurance kicks in. As a general rule, low-premium insurance plans have high deductibles and high-premium plans have low deductibles. .
These are the basic coverage levels:
All catastrophic, bronze, silver, gold, and platinum plans offer free or discounted doctor visits for things like routine checkups or shots and some preventive care. most plans also offer discounts on prescription drugs and other services. however, specific benefits differ from plan to plan, 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.
When can I start using my insurance?
Once you’ve signed up for a plan and paid your first month’s premium, you or your child can start using the insurance. The insurance company must send you and everyone covered by your policy insurance cards with your policy number and other information. If you or your child needs to see a doctor or go to a hospital before you get 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 yourself 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 for payment 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 and learn what you can about the primary care doctors in your plan’s network, then choose a doctor you like. once you’ve done that, schedule checkups and use your insurance to help keep your family healthy.