FAQ’s

No matter what your age or the condition of your health, everyone needs health insurance. Illness and injury can happen to anyone at any time. Healthcare insurance protects you from unexpected, disastrous medical costs as well as providing access to routine and preventive care if you have health insurance.

Under the Affordable Care Act everyone is required to have some sort of healthcare insurance. If you’re not covered, you’ll have to pay a penalty to the IRS for every month you don’t have coverage.

Also known as “Obamacare”, the Affordable Care Act, or ACA, (short for Patient Protection and Affordable Care Act) was signed into law in 2010.

The ACA is designed to provide you with access to quality healthcare for all Americans while curbing the costs of healthcare insurance. It expands the benefits, rights and protections for the insured while creating new rules and regulations for insurance companies to keep medical costs down.

The ACA sets up healthcare marketplaces or “exchanges” where you can shop for insurance plans that provide the coverage you need at rates you can afford.

Many companies provide health insurance for their employees, although enrollment is generally limited to certain periods of the year. Check with your company’s HR department to find out what kinds of coverage plans your employer offers.

Individuals not covered by employer plans can purchase health care for themselves or their families using the ACA’s marketplaces.

Under the ACA, insurance companies can no longer deny healthcare coverage to persons with pre-existing medical conditions. Nor can they drop individuals when they become ill.

This is the annual period when you can enroll in a health insurance plan. The open enrollment period for 2017 runs from November 1, 2016 to January 31, 2017. Employer-based plans may have different open enrollment Periods. Check with your employer to find out when your company’s open enrollment period is.

If you fail to get insurance coverage during the open enrolment period you may still be able to enroll in a health plan if you qualify for a special enrollment period. A special enrollment period only applies during certain circumstances, like getting married, having a baby, or losing other health coverage.

You can apply and enroll in a Medicaid or the Children’s Health Insurance Program (CHIP) any time of year.

The government provides tax credits and other subsidies to individuals and families that can’t afford health care insurance.

Your insurance deductible is a set amount of money you are required pay toward your medical bills before your insurance company starts paying. These rates vary from plan to plan. Generally, the higher the deductible, the more inexpensive the premiums are. Some plans have no deductible.

Similar to a deductible, your copayment, or copay, is the flat fee you pay every time you go to the doctor or fill a prescription. It’s important to remember that co-payments s do not count toward your deductible.

When you go with a Health Maintenance Organization (HMO) health plan, you pick a single primary care physician. This results in lower costs because all your health care services are handled by a single office. You’ll require a referral from your primary care physician before you can seek the services of another health care professional (except in cases of medical emergencies).

One of the great things about Preferred Payment Organization (PPO) plans is that they provide many options when it comes to choosing who and where you get your healthcare from. A PPO plan lets you get healthcare from any professional you wish, even if they are not a part of your healthcare network.

Be advised that there could be additional out-of-pocket costs associated with seeing a healthcare professional that’s not a part of your network and some services may not be covered.

Gap Insurance is designed to help pay the costs your health insurance plan may not cover.