When choosing health insurance, deadlines are important. Miss one, and you could be faced with thousands of dollars in medical bills on the street.
From November 1 through December 15 (in most states), uninsured Americans can sign up for coverage under the Affordable Care Act or renew existing coverage.
If you want coverage in 2021, you will need to enroll during those 45 days unless you have one later qualifying life event, how to get married or divorced.
Some younger and healthier people may not think the coverage is worth the monthly premiums.
But think again, says Gerald Kominski, professor of health policy and management at UCLA.
“There is the idea:” I take care of myself, I live a healthy lifestyle, I eat well, I don’t smoke – I will be healthy and live forever, “he says.” Nobody knows what the future holds. People with a perfectly healthy lifestyle get sick every day. “
It costs up to $ 7,500 to repair a broken leg, about $ 30,000 for three days in the hospital, and hundreds of thousands of dollars to treat cancer. HealthCare.gov says. Average visit to an emergency room in 2017 costs $ 1,389, according to the Health Care Cost Institute.
Most workers cannot cover these types of expenses with their salaries or savings, says Kominski, who three decades ago required an appendicectomy as a graduate student that cost $ 15,000. Because he had a student policy, he said his share was less than $ 100.
In addition, health insurance plans that offer free or low-cost prevention services and encourage early detection of problems reduce the likelihood that more expensive and comprehensive treatment will be required later, said Jay Wolfson, professor of public health, medicine and pharmacy at the University of South Florida . Thus, they also benefit people who are – or appear to be healthy.
And when healthier people buy insurance, it costs less for everyone, he said.
How to sign up for ACA health insurance
Start with HealthCare.gov and click “Take the first step to apply” if this is your first time signing up, or “Sign up to review / change plans” if you had a 2020 plan through the marketplace, also known as “exchange”.
Some states operate their own stock exchanges. If you live California, Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, new York, Pennsylvania, Rhode Island, Vermont, Washington or the District of Columbiayou need to apply through your state.
The application deadlines are a little later in Massachusetts, Minnesota, Nevada, New Jersey, New York, Pennsylvania, Rhode Island and the District of Columbia. So be sure to give or check your state exchange website. Generally, reporting will begin on January 1, 2021.
Find out how to do it online Estimate your income for 2021 for the application and find one Checklist with information As well as household size, you need the social security numbers and dates of birth of your family members, W-2 forms or pay slips and insurance numbers of all current health insurances. Coverage is only available to U.S. residents and lawful residents.
With insurance through the marketplace, you will pay a deductible and Co-insurance – a percentage of an insured health service. The amount depends on which plan you choose. You only have to pay up to a maximum out of pocket, and there are no annual or lifetime dollar limits.
You also benefit from Discounts that insurance companies negotiate with healthcare providers. People without insurance pay almost twice as much for care, according to HealthCare.gov.
How do I apply, what is covered and what help is available?
You can apply to phone, personally with the help of a navigator – a person specially trained to guide you through the process – a Agent or broker or by mail with a Paper application. Marketplace-certified volunteers may also be available through non-profit organizations such as community health centers or hospitals.
Insurance coverage through the health insurance market is aimed at people who are not covered by labor insurance or government programs like Medicaid, Medicare, Tricare (for military personnel, veterans and their families) or CHIP, the children’s health insurance plan.
Plans that comply with the Affordable Care Act cannot discriminate against people with Preconditions. You must also cover birth control and breastfeeding equipment, as well as counseling 10 “essential” services::
- Outpatient care.
- Emergency services.
- Pregnancy, Maternity, and Newborn Care.
- Mental health and substance abuse.
- Prescription drugs.
- Mental and physical rehabilitation for people with injuries, disabilities or chronic illnesses.
- Laboratory services.
- Preventive and wellness services and chronic disease management.
- Pediatric treatment, including dental and visual care.
Depending on the plan you choose, you pay different premiums and expenses. The government will subsidize your premiums if your income is up between 100% and 400% of federal poverty.
The lower your income, the higher it is Tax credit You are entitled to (i.e., the help you receive).
What are the plans?
Insurers sell plans in four categories: Bronze (the lowest coverage and the lowest premiums), silver, gold and platinum (the highest coverage and the highest premiums). Depending on where you live, you might find one different types of plans at every level.
You have the choice between:
- An Exclusive Provider Organization (EPA)This includes services that are only provided by doctors and hospitals on a network, except in an emergency. You don’t have to choose a primary provider.
- An Organization for the Preservation of Health (HMO)This will require you to seek treatment from or contract with doctors who work for the HMO, except in an emergency. You may have to live or work in the HMO service area.
- A point of service (POS) planThis costs less when you use healthcare providers that are part of a network, and you need to get a referral from your GP to see a specialist.
- A preferred provider organization (PPO)where you pay less for network-internal providers, but can go to network-independent providers for an additional fee. You don’t need a referral to go to a specialist.
Disaster insurance is another alternative for those under the age of 30 and for those who can make a claim Hardness releaselike homelessness, domestic violence, or bankruptcy. You must apply for liberation.
On the other hand, disaster plans cover the 10 essential health benefits that are specific preventive services free of charge and cover at least three doctor visits per year before the deductible is met. They also cost about a third as much as larger plans.
The big downside is that the deductible – the amount the patient has to pay before the insurance company starts sharing the cost – was $ 8,150 for 2020 Policyholders are not eligible for a tax credit.
UCLA’s Kominski suggests that consumers compare the coverage and cost of a child plan on the marketplace before deciding on a contingency plan.
Susan Jacobson is a former associate editor at The Penny Hoarder.
This article originally appeared on www.thepennyhoarder.com