FORT WAYNE, Ind. (WANE) —If you are buying health insurance outside a job-based plan you may be in luck this fall.
This year citizens will have more time to sign up, more free help choosing a plan and a greater likelihood of being eligible for subsidies to help keep down the cost of a health plan.
“It’s a really great time to start looking at your options,” said Dr. Julie Daftari, Chief Medical Officer for Indiana Medicare and Retirement. “Whether you are looking for a health plan for the first time or really looking at your current plan and how it meets your needs. It’s always a good time to start exploring what benefits and services are that might be available to you.”
The open enrollment period for 2022 health insurance coverage through the Marketplace starts on Nov. 1 and runs through Jan. 15, 2022. Consumers will need to enroll by Dec. 15 if they need coverage to start by Jan. 1, 2022.
Do you need Health Insurance?
The short answer is yes. Everyone needs some type of health insurance and every year you must re-enroll in health insurance.
Health insurance or medical insurance is a type of insurance that covers medical expenses that arise due to an illness. These expenses could be related to hospitalization costs, cost of medicines, or doctor consultation fees.
While some employers offer health insurance, others don’t.
But what coverage is best for you and your family?
Benefits of Health Insurance
Health insurance provides financial protection in case you have a serious accident or illness. For example, a broken leg can cost up to $7,500. Health coverage can help protect you from high, unexpected costs.
Getting recommended preventive services is a key step to good health and well-being.
Basics terms of Health Insurance
When it comes to picking out a health care plan for many first-time health insurance shoppers, there are several basic terms they may not know:
- Premium: The upfront amount you’ll pay each month to have health insurance
- Deductible: The amount you’ll pay for health care services before your insurance kicks in
- Copayment: Also called a copay, it’s a flat amount you’ll pay for specific services or medication, even if you’ve reached your deductible.
- Coinsurance: Unlike a copay, which is a flat amount, coinsurance is a fee you pay that is a percentage of the cost of a covered service.
- Enrollment: Is a time of year where residents can sign up or update their health insurance coverage.
Where to sign up for health insurance
A majority of employers offer some time of health insurance plan. If you’re signing up for a plan through your employer you may just ask a coworker or your human resource representative questions about benefits.
One of the first tabs that open when you go to HealthCare.gov shows how to start the signup process. However, for those signing up for the Affordable Care Act, the number of choices can be overwhelming.
If you are signing up for health insurance you can do so online, by mail or you can contact an agent or certified enrollment specialist to help you. One way to find a specialist is through Indiana Navigator. Their job is to assist consumers with the process to apply for health insurance and Marketplace enrollment questions. There are navigators located in every county in Indiana.
How much is health insurance?
The cost of health insurance will be different for each person and each family.
The NAIC’s Health Insurance Shopping Tool can help consumers understand how different policies support their health care needs. The tool provides a 3-step process to compare different health insurance policies.
The Health Insurance Marketplace Calculator, developed by the Kaiser Family Foundation, may also be helpful. The calculator will estimate health insurance premiums and subsidies for people purchasing marketplace coverage. With the calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use the calculator to estimate your eligibility for Medicaid. As eligibility requirements may vary by state, please contact your state’s Medicaid office.
What is Medicare?
If you’re 65 or older, you’re eligible for Medicare. It’s a federally run program — the government pays for much of your health care. You might also be eligible if you have certain disabilities. For those already enrolled in Medicare or in a Medicare Advantage plan, the open enrollment period to switch up your supplemental health and prescription drug plans for 2022 runs through Dec. 7.
Consumers in Indiana who currently have Marketplace coverage, or will need it in 2022, should make time to shop for plans through Healthcare.gov.
What happens if you don’t have health insurance?
If you don’t get health insurance, you will have to pay a tax penalty (a fine), unless you qualify for an exemption. Exemptions include:
- Are not a U.S. citizen, a U.S. national or a resident alien legally allowed in the U.S.
- Do not have insurance for less than three months in a row during the year
- Won’t file a tax return because you do not make enough money
- Cannot get Medicaid because Indiana did not expand Medicaid
- Are in a health care sharing ministry or a part of a recognized religious group who objects to health insurance
- Are a member of a government recognized Indian Tribe
- Are in jail
For Medicaid, Dr. Daftari says that you will be enrolled in Medicaid but it may not be the plan that is best for you.
Beware of scams
When looking for health insurance it’s wise not to put your information on random websites or click on ads for health insurance.
Unfortunately, there are a lot of con artists out there who take advantage of the fact that people recognize health insurance. Dr. Daftari’s advice is to go straight to Healthcare.gov.
Conclusion: Sign Up
Though signing up for health insurance can be confusing at first, it’s also very important for both your wallet and your health.