Understanding how to get health insurance insurance can be a difficult and confusing task. There are many factors that can play a role in your decision making process. Before enrolling in a health insurance plan, we would like to point out some basic information to help you learn how to get the right health insurance plan that covers your needs. The first concern many individuals and families have are associated with cost. Let’s learn more about how insurance companies establish their pricing.
What determines the cost of your health insurance plan?
- Your family size
- The ages of the individuals on the plan
- Your home zip code
Why does family size and age determine the cost of your health insurance plan?
The more individuals on a plan, and the older the individuals are on a plan, the more expensive the plan will become. The bigger the group, and the older the individuals are on that group, will always equal a greater health insurance cost for the insurer.
Why is your zip code important?
Since the implementation of Covered California, not all insurance companies cover individuals in all California counties. For example, Health Net will not cover individuals and families in Alameda County, but they will cover individuals and families in Contra Costa and Santa Clara County. Knowing what zip code you live in is crucial for you to understand how much your health insurance monthly premium will be, as well as which health insurance plan you should choose.
Now that we know what goes into the cost of your insurance plan, let’s review what information you need to get a quote.
What you will need to get a health insurance quote:
- Names of all individuals and family members who will be on the plan.
- Birthdates of all individuals and family members who will be on the plan.
- Zip code of where the policy will be taking place.
Two important questions to ask yourself before choosing a health insurance plan:
- What health insurance policies does your doctor’s office accept?
- What health insurance policy does your local emergency room accept?
The two questions above are incredibly important to think about before choosing a plan. The last thing you want to do is pick an insurance policy that either your doctor or local emergency room does not accept. Not alone will you lose your doctor and have to choose another one, you could be at risk of out of network expenses due to an emergency situation. Going to an emergency room that is out of network could be a huge financial hardship. Costs can easily be in the tens to hundreds of thousands of dollars. Now that you know more about how to choose the right insurance plan, let’s review how open enrollment has changed.
How Open Enrollment has changed
Before Covered California, Californians could enroll in a new health insurance policy whenever they wanted. Unfortunately, all of that has changed. Currently the Affordable Care Act mandates that all people apply during open enrollment. 2018’s open enrollment is between the months of November 1, 2018 – January 31st, 2019. If you are looking to enroll in a new plan before, or after these dates, you must qualify for special open enrollment.
To qualify for special open enrollment, you must apply for a new health insurance within 60 days of a qualifying life event.
Examples of qualifying life events are:
- Expiration of Cobra
- Employer no longer offers health benefits
- Marriage or Divorce
- Birth of a baby
- Adopting or Fostering a child
- Moving your residence
- Gaining citizenship
- Aging out of your parent’s plan
What if you do not have a qualifying life event to enroll for health insurance?
If you miss open enrollment, or voluntarily end your health insurance coverage, you do not qualify for the special enrollment period and you will not be able to purchase health insurance until the following year. You can enroll in a short-term health insurance plan that can cover catastrophic hospital bills. However, those plans do not meet the mandatory minimum coverage needed to not receive the health insurance tax penalty.
Where to go to learn more about how to get health insurance
We are independent health insurance agents that represent all major insurance companies
Utilizing a health insurance agent can be a huge help when trying to find the right insurance plan that fits the needs of you and your family. Here at BLV Insurance Services, we have over 30 years experience helping individuals, families and small businesses, throughout the Bay Area, choose the right health insurance plan. We are experts in the following health insurance plans: