If you’re looking for the right health insurance plan for you, the best way to start is by learning everything you can about health insurance in general. Our comprehensive guide below will help you in your search. We’ll give you an idea of the differences between all of the available plans. As well as answer all the most common questions about health insurance.
Once you’ve got a more general idea of how health insurance works, think about your household income so you can create a budget that will work for you. This way you will be able to easily weed out plans that are too expensive. As you research plans and prices, jot down any questions you want answered. Then contact an EZ agent, who will answer all of your questions. As well as look at all of your information and help you find the perfect plan that fits your budget. But let’s start with some general FAQs about health insurance.
How much does health insurance cost?
Unfortunately, there is no simple answer to the question of how much a health insurance plan will cost for you. Health insurance prices depend on a variety of factors. Such as your age, where you live, the plan you choose, and the insurer you choose.
But with that being said, we can still help give you a general idea of what you can expect to pay. Check out our state-by-state guide to health insurance. Where you can see the best insurance companies in your state, how much plans cost on average. Even ways you can save on your health insurance premiums.
And once you’ve taken a look at your state’s guide, the easiest way to find out exactly how much insurance will cost you is to use the EZ online quote tool. We can give you free instant quotes that are specifically tailored to you. Enter your zip code in the bar above or call us at 877-670-3557.
What – and when – is Open Enrollment?
The annual Open Enrollment Period (OEP) is a window of time when you can sign up for a variety of health insurance plans that comply with the Affordable Care Act. You will also be able to make changes to your existing coverage or even drop your plan entirely.
The Open Enrollment Period is generally the same in all states. But some states may choose to start their OEPs at an earlier time. These states typically do not take part in the federal marketplace but rather have their own marketplaces that are run by the state. The important OEP dates for 2023 are:
November 1st – This is the first day of the OEP. This is when you can begin to enroll in a health insurance plan, make adjustments to your current plan. Or switch plans all together. Your coverage will start January 1st of 2024.
December 15th – This is the last day you can enroll or change your plan if you want coverage to start on January 1st. This isn’t the end of OEP, just the last day you can enroll to start your coverage by the 1st of the year.
January 1st – If you enrolled or made changes between the dates above this is when your new plan or those changes go into effect.
January 15th – OEP ends. This is the last day you can enroll in a new plan or change anything about your current plan. If you miss the OEP, you’ll have to wait until the next year’s OEP to do anything, unless you qualify for a Special Enrollment Period.
February 1st – If you enrolled or made changes after December 15th this is when your coverage or changes will start.
What is a Special Enrollment Period?
If you experience a major life change known as a qualifying life event, you may be eligible for a Special Enrollment Period (SEP) that gives you additional time to make changes to your health insurance plan. You can usually enroll in a new health plan through the federal or state-based marketplaces within the 60-day Special Enrollment Period following your qualifying life event.
You will have to wait until the next Open Enrollment Period to make the necessary changes to your health insurance if you do not take action during your Special Enrollment Period.
Examples of qualifying life events that can trigger a Special Enrollment Period include:
Loss of coverage – If you lose your current coverage because of losing your job, your insurer no longer offering coverage in your area, or aging out of your parent’s plan, you will be given an SEP.
Household changes – This can include a lot of events. A SEP may become available to you if you enter into a legally recognized marriage, have a child, adopt a child, or place a child in foster care. Those who have gone through a divorce or legal separation and consequently lost their health insurance are also eligible. A death in the family that results in the loss of health insurance would also be considered a change in the household. Keep in mind that domestic partnership laws and regulations can vary from state to state.
Change in residence – Relocating is generally accepted as a qualifying life event. Moving to a new area code, or entering the United States from a foreign country or U.S. territory, allows you to switch healthcare plans. This includes college students moving to or away from school. This also includes seasonal workers who commute to and from their place of employment.
Other – You will also be permitted to make adjustments to your health insurance plan if you discover an error in your enrollment or policy information. Domestic violence survivors also have the right to a separate health insurance plan from their abuser through a Special Enrollment Period. Individuals released from prison may also be eligible for a SEP.
If you are a single adult without dependent children, you will only be able to purchase individual health insurance. But you also don’t necessarily have to have a family health insurance plan just because you are not single. It is possible for you and your partner to have separate health insurance policies; the decision should be made based on what will be most cost-effective for you.
For example, if you are generally healthy and don’t see the doctor often, but your partner has a chronic medical condition, it might make more sense for you to have a high deductible health insurance plan, and your partner to have a plan with higher premiums and a lower deductible.
HMOs give you a network of doctors, hospitals, and other health care providers and facilities in your area you can choose from. As part of these health insurance plans, you must choose a primary care provider (PCP) from this network. Your PCP will get to know you and help you plan all of your medical care. They are also in charge of giving you referrals to a specialist. Without a referral, your HMO won’t pay for a visit to a specialist.
PPOs have very large networks of providers who work with them. This means you can choose from a wide range of hospitals, clinics, and other medical facilities and specialists. PPOs, unlike HMOs, will pay some of the bill for providers outside of their network. But not as much as they would for a provider in their network. Another big difference between PPOs and HMOs is that you don’t have to choose a PCP and you don’t need a referral to see a specialist with a PPO.
3.Exclusive Provider Organizations (EPOs)
EPOs also connect you to a network of providers from which you can choose. Most EPO plans do not cover care that is received outside of their network, unless it is an emergency. So, if you go to a provider or facility that is not part of the plan’s local network, you will likely have to pay for all of the services yourself. Depending on the plan, you might have to choose a PCP, or you might not have to. Either way, you don’t need a referral from your PCP to see a specialist. As long as they are in the plan’s network.
4.Point-of-Service (POS)
POS plans combine some aspects of both HMOs and PPOs. Like a HMO, a POS plan’s network of providers is often smaller than that of a PPO plan. Like a PPO plan, the costs of care from providers in the network are usually lower. And also as with HMOs, with POS plans, you have to choose a primary care provider (PCP) from the network of doctors and other primary care specialists. You also need a referral to see a specialist.
What type of plan should I get?
When deciding on a health insurance plan, it is important to consider how easily you will be able to see a doctor who participates in that plan’s network. There are health insurance plans, like HMOs, that will not cover visits to an out-of-network provider at all. And others that will cover only a portion of such visits.
Why Should I Use EZ?
Working with an agent saves you time and stress because you won’t have to try to figure out legal jargon or read small print. Agents do all the hard work. So, you can relax knowing that your coverage will best meet your financial and medical needs.
Not to mention that EZ agents can save you hundreds of dollars a year on your health insurance premiums. We do this by looking for the cheapest plans both on and off the market. As well as finding and applying any discounts you might be able to get. We don’t just help you find a plan, though. Additionally, we also help you keep it up-to-date. We can help you file claims with your insurance company and help you renew your policy when it’s time. To start, simply enter your zip code in the box below. Or call 877-670-3557 to talk to one of our licensed agents.
About The Author:
Cassandra Love
With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.
