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Contents tagged with health insurance 101

How Does Dental Insurance Work? A Quick Primer

Posted Sep 22, 2017
By Jenifer Dorsey

How Does Dental Insurance Work? A Quick Primer

 

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Where Can I Get Health Insurance Now?

Posted Sep 07, 2017
By Jenifer Dorsey

Where Can I Get Health Insurance Now?

In some ways, buying an individual health insurance plan can seem relatively easy. You can search for and compare a range of plans from different carriers at your convenience, and you can get online health insurance quotes in seconds. Then, depending on the coverage you choose, the application and enrollment process may take only a few minutes.

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Health Insurance Deductible 101

Posted Jul 10, 2017
By Jenifer Dorsey

Health Insurance Deductible 101

Welcome to Health Insurance Deductible 101. It’s time to get to know one of your health plan’s key components and better understand how health insurance works.

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This Could Be Your Plan

Posted Apr 21, 2017
By Jenifer Dorsey

This Could Be Your Plan

You need health insurance, and you need it soon. But there’s a bit of a problem: Open enrollment for 2017 Obamacare plans ended January 31, and you do not qualify for a special enrollment period to purchase one now.

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What is a Fixed-Indemnity Health Plan?

Posted Jan 20, 2017
By Jenifer Dorsey

What is a Fixed-Indemnity Health Plan?

Sometimes, just as you are getting a grasp on major medical plan lingo and how the coverage works, you come across yet another health insurance term you don’t quite understand. Let’s say, for instance, fixed-indemnity plan.

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Under Pressure?

Posted Jan 17, 2017
By Jenifer Dorsey

Under Pressure?

2017 open enrollment ends on January 31 – just two weeks from now. There are many reasons people have put off purchasing coverage until the last minute, but uncertainty may be the common theme – uncertainty over the future of the ACA, uncertainty over which plan to purchase, uncertainty over what you can afford.

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How Much Will Obamacare Cost You in 2017?

Posted Dec 13, 2016
By Jenifer Dorsey

How Much Will Obamacare Cost You in 2017?

Double-digit rate hikes averaging 25 percent nationwide made headlines just before 2017 open enrollment began on Nov. 1.[1] In Arizona, rates went up an average of 57 percent.[2] In Ohio, the average hike was 17.3 percent.

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Choosing the Wrong Obamacare Health Plan Could Cost You

Posted Dec 06, 2016
By Jenifer Dorsey

Choosing the Wrong Obamacare Health Plan Could Cost You

Many don’t have the luxury of choosing a health insurance plan without cost in mind, but you could save money if you select 2017 coverage based on more than monthly premium. And, on the flip side, choosing coverage based solely on monthly premium could mean paying more money for the healthcare you need.

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Networking 101: What are Health Insurance HMOs, PPOs, and EPOs? And, how are they different?

Posted Nov 17, 2016
By Jenifer Dorsey

Networking 101: What are Health Insurance HMOs, PPOs, and EPOs? And, how are they different?

Health insurance provider networks are groups of hospitals, clinics, doctors and specialists who are contracted with that network. The network then contracts with a health insurance carrier; the plans offered by that carrier can include in-network benefits with contracted providers. Health plans may set specific parameters around seeking care from in- and out-of-network providers

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Should I Buy from the Health Insurance Marketplace or Outside It?

Posted Nov 15, 2016
By Jenifer Dorsey

Should I Buy from the Health Insurance Marketplace or Outside It?

What's the best place to buy Obamacare plans?

When the Affordable Care Act’s first Obamacare open-enrollment period commenced Oct. 1, 2013, consumers were introduced to state-based and federally facilitated health insurance exchanges known as the Health Insurance Marketplace.

Consumers in all 50 states and the District of Columbia may purchase individual major medical plans through the Health Insurance Marketplace; however, it is not the only place to buy them. Major medical health insurance is also available outside the government-run exchanges in the private marketplace. 

Before you shop for your next health plan, be aware of similarities and differences between the on- and off-exchange shopping experiences.

 

Find a local agent!

 

What is the difference between exchange-based health plans and those sold in the private marketplace?

First, let’s look at how they are the same. 

All major medical plans sold through Obamacare’s Health Insurance Marketplace and in the private marketplace qualify as minimum essential coverage that fulfills the ACA’s shared responsibility provision. 

No matter where they are sold, these plans must also include all of the Affordable Care Act’s consumer protections and benefits, such as1:

  • Items and services in the 10 essential health benefits categories
  • No-cost preventive care – certain preventive care screenings, tests and services at no additional cost beyond your premium
  • Coverage for children up to age 26
  • Guarantee-issue coverage – you cannot be denied or charged more based on your health history or gender

Furthermore, your rate can only be determined by the following five factors2:

  1. Age (older people can only be charged up to three times more than younger people)
  2. Geographic location
  3. Tobacco use
  4. Individual vs. family enrollment
  5. Plan category – bronze, silver, gold, platinum, catastrophic

Now, let’s look at the differences between plans sold through the Health Insurance Marketplace and those sold in the private marketplace. 

It comes down to two key factors:

  1. Subsidies
  2. Networks

The major medical insurance you buy from the Health Insurance Marketplace:

  • Qualifies for income-based Obamacare subsidies including premium tax credits and cost-sharing reductions
  • May have a narrower provider network—narrow networks are a way insurance companies cut costs on exchange-based plans3

The major medical insurance you buy in the private marketplace:

  • Does not qualify for Obamacare subsidies
  • Tends to have broader provider networks4

It is also worth noting that not all insurance companies sell through the Health Insurance Exchange, and those that do may offer different plan types on and away from it. You can expand your selection by shopping both the private marketplace and Health Insurance Marketplace.

Okay, so where should I buy my health plan?

The answer will vary by household. 

You can see that one marketplace is not necessarily better than the other. Personal circumstances and preferences will play a role in determining where to buy your next health insurance plan.

To determine which route is best for you:

  • Assess your financial situation and healthcare needs
  • Estimate your subsidy eligibility using a tool such as the Health eDeals Health Care Reform Calculator
  • With your subsidy eligibility in mind, comparison shop on and away from the Health Insurance Marketplace, and pay attention to details such as:
    • Monthly premium
    • Deductible, coinsurance and copayment amounts
    • Prescription drug formularies
    • Provider networks

If you decide to buy major medical insurance outside the Health Insurance Marketplace, you can purchase it:

  • Through a health insurance agent or broker
  • From an insurance company
  • On a website such as healthedeals.com

Who can help me?

A health insurance producer (i.e., agent or broker) can familiarize you with your options on and away from the Health Insurance Marketplace, help you assess which plans are a strong match, and discuss with you supplemental plans to round out your coverage.

 

Find a local agent!

 

If you shop the Health Insurance Marketplace, you have access to exchange-based helpers, which include agents and brokers, in-person assisters and call center personnel. 

Remember your dental plan!

Whether you buy your major medical plan on or away from the Health Insurance Marketplace, you should consider buying dental insurance and can buy a plan in the private marketplace—most health insurance exchanges do not offer dental insurance plans for adults. 

Get a quick dental insurance quote at healthedeals.com. While you are there, consider other supplemental coverage such as telemedicine, critical illness and gap plans. These products complement your major medical plan and can help reduce your out-of-pocket healthcare spending.

Have questions? Call the number at the top of your screen to speak with a producer.

 

This article was originally posted October 5, 2015.


1  U.S. Department of Health & Human Services. “Key Features of the Affordable Care Act.” Last reviewed Aug. 13, 2015. http://www.hhs.gov/healthcare/facts/timeline/timeline-text.html

2 HealthCare.gov. “How Marketplace Plans Set Your Health Insurance Premiums.” https://www.healthcare.gov/lower-costs/how-plans-set-your-premiums/

3 Magan, Dan. “Obamacare Health Plans: Enough Doctor Choice?” CNBC. July 16, 2015. http://www.cnbc.com/2015/07/16/obamacare-plans-offer-narrow-health-provider-options-study.html

4 Ibid.

This document is for general informational purposes only. While we have attempted to provide current and accurate information, this information is provided "as is" and we make no representations or warranties regarding its accuracy or completeness. The information provided should not be construed as legal or tax advice or as a recommendation of any kind. External users should seek professional advice from their own attorneys and tax and benefit plan advisers with respect to their individual circumstances and needs.

DENTAL
THIS PLAN DOES NOT MEET MINIMAL ESSENTIAL COVERAGE REQUIREMENTS FOR PEDIATRIC DENTAL SERVICES IN ACCORDANCE WITH THE AFFORDABLE CARE ACT (ACA) PROVISIONS.

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual disability, specialty and supplemental health, pet, and life insurance through its subsidiaries since 1980. The IHC Group owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company) and IHC Specialty Benefits, Inc., which is a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.

IHC Specialty Benefits, Inc.
IHC Specialty Benefits, Inc., doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products via general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit http://www.HealtheDeals.com.

Continue Reading: Should I Buy from the Health Insurance Marketplace or Outside It?

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