Faqs
Health care insurance helps cover the cost of medical expenses, including doctor visits, hospital stays, and prescription medications.
Pre-65 health care insurance refers to health insurance options available for individuals who are under the age of 65 and not yet eligible for Medicare.
Eligibility for health care insurance typically depends on factors such as age, employment status, and whether you are covered under an employer-sponsored plan.
You can apply for health care insurance through an employer, a private insurer, or the government marketplace during open enrollment or after a qualifying life event.
Pre-65 health insurance is for individuals under 65, while Medicare is a federal program available to individuals 65 and older or those with certain disabilities.
In some cases, you can continue your employer-sponsored insurance through COBRA or other retiree benefits, but this is often temporary and may be more expensive.
Health care insurance helps reduce your out-of-pocket expenses for medical services, provides preventive care, and protects against unexpected high medical costs.
The cost varies based on factors such as your location, age, coverage level, and whether it's a group or individual plan.
Coverage typically includes doctor visits, hospital stays, preventive care, prescription drugs, emergency services, and some specialized treatments.
A premium is the amount you pay monthly for your health insurance policy, whether you use medical services or not.
A deductible is the amount you pay out-of-pocket for health care services before your insurance begins to cover costs.
In-network providers have agreed to lower rates with your insurance company, while out-of-network providers typically cost more because they don't have a contract with your insurer.
The individual mandate penalty was repealed in 2019, but some states may still impose penalties for not having health coverage.
A copayment is a fixed amount you pay for a covered health care service after you've paid your deductible.
Coinsurance is the percentage of costs you pay for a covered health care service after you've met your deductible.
Open enrollment typically occurs annually, usually in the fall, though special enrollment periods may be available due to life events.
A special enrollment period allows you to enroll in or change health insurance outside of the open enrollment period due to qualifying life events such as marriage, birth, or loss of coverage.
Yes, depending on your income, you may qualify for subsidies or premium tax credits through the health insurance marketplace.
If you miss open enrollment, you may have to wait until the next period unless you qualify for a special enrollment period.
You can check your insurer’s provider directory or contact the doctor’s office directly to confirm they accept your insurance.
Under the Affordable Care Act, health insurance plans are required to cover pre-existing conditions without charging more.
If your claim is denied, review the reason provided by the insurer and consider filing an appeal with supporting documentation.
Consider your health needs, budget, preferred doctors, and medications when selecting a plan. Compare premiums, deductibles, and out-of-pocket costs.
Preventive care includes services like vaccinations, screenings, and check-ups. Most insurance plans cover these at no additional cost when using in-network providers.
You can change your plan during open enrollment or if you qualify for a special enrollment period due to life changes.
The out-of-pocket maximum is the most you'll pay in a policy year for covered services. Once you reach this limit, your insurance pays 100% for covered services.
COBRA allows you to keep your employer-sponsored health insurance for a limited time after losing your job, though you may have to pay the full premium.
If you move to a different state, you may need to switch to a new health plan that operates in your new location.
You may qualify for tax credits or choose a higher deductible plan with lower monthly premiums. Comparing plans annually can also help find savings.
Short-term health insurance provides temporary coverage, typically for up to 12 months, for individuals in transition, such as between jobs or waiting for other insurance to start.
