The Affordable Care Act (ACA) has created many new options for Fort Wayne Indiana health insurance, and in turn it can be very confusing. One new tool introduced by the ACA is the Health Insurance Marketplace. This is a tool designed to help people to shop for, compare, and ultimately choose the best health insurance plan for their own situation. Enrollment begins in October 2013, and this article will help ensure that you’re prepared to start the process.
1) Understand the different options from the health insurance Marketplace.
Job-based: You may be eligible for health insurance coverage if your employer, or the employer of your spouse or parent, offers health insurance. You cannot be denied coverage based on your current health status, however you may be turned away based on other factors, such as working part-time.
Medicaid: Medicaid provides insurance to people with disabilities, low-income families, and low-income children. It covers services such as outpatient doctor visits, hospital admissions, vaccinations, prescription medications, preventative care for your children, vision, hearing, and long-term care.
Medicare: Medicare provides health insurance to people over the age of 65, people with end-stage renal disease, and people under 65 with certain disabilities. It typically covers: Similar services as Medicaid, but it also may cover skilled nursing facility care and also hospice care.
Children’s Health Insurance Program (CHIP), CHIP provides insurance to low-income children. Coverage can vary from state to state, but all states pay for routine check-ups, hospital admissions, vaccinations, dental care, lab tests, and x-ray services.
2) Have questions prepared to help assist you during your search. For example:
Can I keep my current doctor?
Does this plan’s network include high quality doctors and hospitals?
Will this plan cover my health costs whenever I’m traveling?
3) Understand insurance basics.
Deductible: A deductible is how much you pay before insurance coverage starts. For example if the deductible is $1000, the insured would be required to pay for the first $1000 of medical services themselves before the insurance company begins to pay for any services. A deductible is typically an annual payment, meaning at the end of year, the insured must again pay the deductible before the insurance company will start to contribute any assistance
Out-of-pocket maximum: How much in total you will have to pay if you get ill.
Co-payment (“copay”): A fixed fee the insured must pay each time a medical service is used, For example, you may have to pay a $15 copay every time you visit the doctor’s office.
For more information about how the Health Insurance Marketplace call PMG today!