Finding Health Insurance
Get information on how to find and sign-up for health insurance including the ACA, COBRA, long term care and health care for people with disabilities.
was designed to give individuals and families greater access to affordable health insurance options including medical, dental, vision, and other types of health insurance that they may not have been able to get on their own or through an employer. Under the ACA:
You may be able to purchase health care through a that offers a choice of plans.
Đang chơi bàiInsurers can't refuse coverage based on gender or a pre-existing condition.
Lifetime and annual limits on coverage are eliminated.
Young adults can stay on their family’s insurance plan until age 26.
Seniors who hit the or "donut hole" can get a discount on medications.
and learn more about its provisions and relationship to patients, insurers, businesses, and families.
When to Enroll
Open enrollment is the part of each year that citizens can freely make changes to their health care coverage purchased through the ACA's Health Insurance Marketplace.
The next open enrollment period is expected to begin in early November 2019. During the open enrollment period, you will be able to:
Re-enroll in your current plan
Đang chơi bàiChoose a plan for the first time
Choose a new plan to replace your current plan
Đang chơi bàiMake changes to your existing insurance plan
Đang chơi bàiYou can enroll or change your plan year-round if you have certain life changes:
Đang chơi bàiGetting married or divorced
Đang chơi bàiHaving a baby or adding a dependent to your family
Losing other coverage
Moving to a new state
Đang chơi bàiQualifying for Medicaid or CHIP
Đang chơi bàiCheck to see if your life event qualifies you to change your coverage under a .
How to Enroll and Get Answers to Your Questions
You can learn more about and apply for ACA health care coverage in several ways.
- Go to . Depending on where you live, you'll apply for benefits there through the ACA Health Insurance Marketplace or you'll be directed to your state's health insurance marketplace website. vary by state.
Contact the at 1-800-318-2596 or TTY at 1-855-889-4325.
Find a to apply or ask questions in person.
Download an to apply by mail
Đang chơi bàiFind the answers to about submitting documents, getting and changing coverage, your total costs for health care, tax options, and more.
Using Your Coverage
Đang chơi bàiIf you have questions about specific parts of your insurance plan, you must contact your insurance company to get answers. Only your insurance company can answer specific questions about doctors, medications, treatments, medical equipment, and what is and is not covered under your plan.
Đang chơi bàiIf you can't find out how to contact your insurance company, contact the .
If you need help appealing a dispute with your insurance company, contact the .
Businesses with 50 employees or fewer can offer plans to employees, starting any month of the year. Learn about to help companies with the equivalent of fewer than 25 full-time employees provide insurance coverage to their workers.
A plan you purchase on your own directly from a health insurance company or through the Government programs such as , , or The or for military personnelYour state, if it provides a health insurance planContinuing employer coverage from your former employer, on a temporary basis under the Consolidated Omnibus Budget Reconciliation Act (COBRA)
Types of Health Insurance Plans
When purchasing health insurance, your choices typically fall into one of three categories:
- Traditional fee-for-service health insurance plans are usually the most expensive choice, but they offer you the most flexibility in choosing health care providers.
- offer lower co-payments and cover the costs of more preventive care, but your choice of health care providers is limited to those who are part of the plan.
- offer lower co-payments like HMOs but give you more flexibility in selecting a provider.
Choosing a Health Insurance Plan
Đang chơi bàiRead the fine print when choosing among different health care plans. Also ask a lot of questions, such as:
- Do I have the right to go to any doctor, hospital, clinic, or pharmacy I choose?
- Are specialists, such as eye doctors and dentists, covered?
- Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
- Does the plan cover home care or nursing home care?
- Will the plan cover all medications my physician may prescribe?
- What are the deductibles? Are there any co-payments? Deductibles are the amount you must pay before your insurance company will pay a claim. These differ from co-payments, which are the amount of money you pay when you receive medical services or a prescription.
- What is the most I will have to pay out of my own pocket to cover expenses?
- If there is a dispute about a bill or service, how is it handled?
Đang chơi bài
Get More Information or File a Complaint
For questions or complaints about your COBRA coverage, contact your plan administrator or the Employee Benefits Security Administration. Note: In some cases, you can change from COBRA coverage to .
Find local Learn about to consider
Long-Term Care Insurance
Most health insurance plans and Medicare severely limit or exclude long-term care. If you want coverage, you may need a separate long-term care insurance policy. You should consider the cost of long-term care insurance as you plan for retirement.
Đang chơi bàiThese questions can help you evaluate long-term care insurance policies.
- What qualifies you for benefits? Some insurers say you must be unable to perform a specific number of the following activities of daily living: eating, walking, getting from bed to a chair, dressing, bathing, using a toilet, and remaining continent.
- What type of care is covered? Does the policy cover nursing home care? What about coverage for assisted living facilities that provide less client care than a nursing home? If you want to stay in your home, will it pay for care provided by visiting nurses and therapists? What about help with food preparation and housecleaning?
- What will the benefits amount be? Most plans are written to provide a specific dollar benefit per day. The benefit for home care is usually about half the nursing-home benefit. But some policies pay the same for both forms of care. Other plans pay only for your actual expenses.
- What is the benefits period? It is possible to get a policy with lifetime benefits but this can be very expensive. Other options for coverage are from one to six years. The average nursing home stay is about 2.5 years.
- Is the benefit adjusted for inflation? If you buy a policy prior to age 60, you face the risk that a fixed daily benefit will not be enough by the time you need it.
- Is there a waiting period before benefits begin? A 20 to 100 day period is not unusual.
Complaints about Long-Term Care
To report an emergency where there is immediate danger, call 911 or contact your local authorities.
Đang chơi bàiIf you have a complaint about a long-term-care facility, reach out to the to find a state's long-term care ombudsman program.
If you have an elder abuse complaint, contact your long-term ombudsman or local resources.
Health Insurance and Health Resources for People with Disabilities
Đang chơi bàiFind information about health insurance and resources for people with disabilities.
Health Coverage for People With Disabilities
If you have a disability, you have a three options for health coverage through the government.
Health Resources for People With Disabilities
Đang chơi bàiFederal, state, and local government agencies and programs can help with your health needs if you have a disability.
Explore the of CDC.gov for articles, programs, tips for healthy living and more.
Learn more about from the Social Security Administration.
Contact your local city or county government to find out what medical and health services are available locally for people with disabilities.
Your state social service agency can help you locate medical and health programs.
Visit USA.gov’s Government Benefits Đang chơi bàipage to learn more about government programs and services that can help you and your family.
Do you have a question?
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Ask a real person any government-related question for free. They'll get you the answer or let you know where to find it.
November 23, 2020