Blog

Health Insurance 101: How to Get Covered

Getting health insurance coverage is up there with doing your taxes and paying bills as one of those important things that nobody particularly enjoys doing. If you’ve been putting it off forever, today is the day to sort it out. Here we tell you what you need to know to get covered:

Health Insurance Marketplace

The new health care law (the Patient Protection and Affordable Care Act, frequently called Obamacare) has established a Health Insurance Marketplace in each state, making it easy to sort out all your health insurance needs in one place. You can compare all the available options side by side and then pick the one that suits your needs and budget.

Here are the key points about U.S. health insurance coverage:

• There is financial assistance on offer.
• You pay nothing for preventive care.
• Free help is available with applications.
• Pre-existing conditions cannot be used to deny you coverage.
• Each plan’s costs and features must be outlined clearly (with no fine print).
• Every health insurance plan must cover important benefits, such as doctor visits, hospitalizations, and prescriptions.

Why Should I Buy Health Insurance?

Insurance is available for everything from travel to pets, giving you reassurance and peace of mind in many areas of life. Your health is considerably more important than, say, your cell phone, so why leave yourself exposed to massive medical bills if you get injured or sick? Even if you are in great health and feel fantastic, you never know when an accident might occur, or when a family history of diabetes or cancer might catch up with you. Don’t gamble with your future; get quality health insurance and enjoy protection and peace of mind.

What Your Health Insurance Covers:

• Free preventive care, including screening for blood pressure, cholesterol, and colorectal cancer, vaccinations, pap smears, and mammograms
• Prescriptions
• Mental health services
• Emergency services and hospitalizations
• Maternity care
• Care for infants and children

Your Health Insurance Options:

The four categories of health plan differ according to the coverage offered and the monthly costs involved. They are Bronze, Silver, Gold, and Platinum. Remember to check that your chosen Comiere doctor is covered by the plan you choose.

Bronze Plans

The basic Bronze plan offers the lowest monthly costs, but it will cost more if you have to visit the doctor or fill a prescription. This plan is most appropriate for those who rarely visit the doctor or need prescription drugs. Bronze plans generally cover about 60% of medical costs, so you cover the remaining 40%. Check if your current hospital and/or doctor (and prescriptions) are included in a plan before you choose it.

Silver Plans

A Silver plan is a step up from a Bronze plan, covering 70% of medical costs on average. You will pay about 30%. The monthly cost of the plan is higher than Bronze but lower than Gold. Check whether your current doctor, hospital, and prescriptions are covered under the Silver plan before you choose.

If your income is below $29,175 for an individual or $59,625 for a family of four, you may be eligible for assistance with out-of-pocket costs (costs that the insurance does not cover but that you must pay when you attend the doctor or fill a prescription) when you choose a Silver plan. This will often turn out to be a better deal for you than a Gold or Platinum plan.

Gold Plans

We go up the ladder with Gold category plans. Monthly costs are higher, but so is the coverage for doctor visits and drugs. You will be covered for an average of 80% of medical costs, so that you pay about 20%. Again, ensure that your current doctor, hospital, and prescription drugs are covered under the plan before you choose.

Platinum Plans

A Platinum plan offers the maximum level of coverage available—some 90% of medical costs—so if you visit the doctor frequently and/or need significant amount of prescription drugs, this is the plan for you. The monthly costs are the highest of all the plans, but you will only pay 10% of any costs for doctors and prescriptions. As with all plans, ensure your chosen doctor, hospital, and prescription drugs are covered in the plan you sign up for.

Financial Assistance

More than 80% of people signed up for health insurance receive financial assistance. The level of financial assistance available depends on the applicant’s income, with some people eligible for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP).

What You Need Before You Sign Up

To make the sign-up process as easy as possible, here are some things you should have to hand before you apply for your health insurance plan of choice:

• Social Security numbers of anyone to be included on your plan
• A recent W-2, pay stub or other equivalent income information
• If you have health insurance already, find a document with the policy number on it. If you don’t have insurance, it does not matter.

A Step-by-Step Guide to the Health Insurance Marketplace:

• Decide whether you are going to apply
• online
• by phone
• by mailing in an application
• with local help
• Assemble information about you and your family, including your income and the number of family members.
• Compare the available options, according to your needs and your budget. Ensure that the doctor you choose with Comiere is covered by the plan. Also, if you are concerned about the cost, remember that more than 4 out of 5 people who already signed up for health insurance received financial assistance.
• Sign up for a plan.

Follow these tips, and you’ll soon have the health insurance coverage you need. Then you can browse the quality healthcare professionals in your area and arrange your appointments using our convenient booking system. It’s health care the easy way.