Often times I hear complaints about an ACA Marketplace Plan stating that it did not cover an OBGYN visit. The question that comes is, “I thought these visits are covered because of Obamacare?” The short answer is, they are. However, there are some rules that you need to know about regarding whether or not a visit is covered as free/preventative under the Affordable Care Act.
Mammograms are only covered for women who are over the age of 40. Pap smears are covered once every three years for women 21-65. These are not covered for everyone or every year.
It is important to know and understand what is or is not covered under the Affordable Care Act before you go to the doctor so you are not surprised when you receive a bill. Insurers may elect to cover these services for a broader range of customer and more often, but these are the minimum requirements.
For more information, visit healthcare.gov
Today is the last day for open enrollment for 2019. If you do not select a plan by midnight tonight, you will not be eligible to receive subsidies for 2019 without a special circumstance.
Don’t miss out on your opportunity to select from the maximum number of options for your health coverage in 2019. Call today 1-888-630-3826!
The ruling has not placed an injunction on the current market so nothing changes yet. We are still monitoring the situation. There will likely be an appeal process. Any updates will be reflected on our updates page.
We are aware of the news that dropped moments ago that a federal judge has ruled the Affordable Care Act, known as Obamacare, to be Unconstitutional and invalidated.
We do not know any details of how this will impact health coverage for 2019 at this time. We will update you as soon as we know something more.
When was the last time you checked the market for a different health insurance plan? Why should you?
The fact is that in the era of Obamacare new plans are constantly becoming available and old plans are constantly changing or going away altogether. What does this mean? Often, people are paying too much for their health coverage without even realizing it.
Get a free review of coverage today using the link below so we can get you a quote. There is no requirement to buy and you will find out if you truly have the best coverage that is available to you.
Schedule A Free Review
For the last few years short-term health insurance plans have only been allowed to last for a maximum coverage period of three months. This decision forced many families into overly expensive health plans in the Healthcare.gov Marketplace.
On October 2nd all of that changed. These plans are now allowed to last for one year just like any other medical plan. This means that you have more options, more networks, and often better prices to choose from.
This, combined with the elimination of the ACA Tax Penalty for not having insurance, means that now is the best time to buy insurance for you and your family.
Please request a free quote today to find out what your options are!
Understanding A Copay
Some insurance plans offer a type of office visit payment called a copay. This term can be confusing as it does not mean the same thing every time.
Typically, a copay is the amount that you are required to pay to be seen for service. That part is easy to understand. The difficult part is whether or not the copay is all you will pay for the service that you are receiving.
Some insurance plans waive the deductible in favor of the copay. That means you do not have to meet your deductible and only have the copayment and any applicable coinsurance. However, many plans require a deductible before you get to pay a copay. This means if your office visit is normally $100 and your copay is $20, you would have to pay the full $100 if your copay has not been met.
Are Copays Right For Me?
The question of whether or not a plan with a copay is right for you depends on what you want your out of pocket costs to be for the year. Typically, plans with copays are higher in monthly premiums. However, your upfront costs for medical services may be cheaper.
This is not a question that is easy to navigate on your own. Our team is available to help explain the plans that you are looking at and to help you decide what plan will give you the best coverage at the best overall prices. Schedule a call today or submit a form to get a free quote.
Can I save money?
Every year Open Enrollment for the Affordable Care Act, also known as Obamacare, starts in November and people always ask what is the cheapest plan they can get? The answer is, it depends!
The Affordable Care Act allows for certain individuals to receive subsidies based on income levels. However, you must first meet a certain income level before you are allowed to receive a subsidy. What does this mean?
For an individual, you must make at least $16,000 per year to receive subsidies in many cases. More information can be found at healthcare.gov about specific income levels.
Is there a downside to subsidies?
As with most things, there are caveats to subsidies. At the end of each year, your subsidy level will be compared to your IRS Tax Return to make sure that you actually qualify for the subsidies you received during the year for healthcare. If your income level is higher than what you reported on your application, you will owe money back to the government for the subsidies that you did not qualify for. This can be fixed by making sure you update any income levels that may change during the year to keep your subsidies and premiums at the proper amount.
How Can I Get Help?
We are here to help you during Open Enrollment as well as the entire year. Our team can help you determine if you are eligible for a subsidy, apply for insurance, and help you keep everything updated throughout the year. To get help, book an appointment using the button below. Or request a free quote, we are happy to help!
Open Enrollment for 2019 begins today. During the next 45 days, you can sign up for any insurance plan on the Healthcare Marketplace without the need for a special enrollment period.
Our team is standing by to help you with this process. Why should you talk to an agent?
- Healthcare is complicated. An agent can help you understand the laws, coverages, and other things about health insurance that impact your life.
- Agents have access to more plans. An agent can help you find the best insurance at the best price. They are professionals and have quick access to all of the plans to find you the best coverage.
- Agents can help you after the purchase. An agent can help with claims and additional things that come up with your insurance carrier throughout the year.
Schedule an appointment today to speak with David during Open Enrollment about how you can get the best bang for your buck in 2019!
It is true that the recently signed into law tax bill does remove the individual mandate from the Affordable Care Act. However, this repeal of the mandate does not go into effect until 2019. This means that you must still have minimum essential coverage for 2018 or face the possibility of a tax penalty.
So what exactly does this mean?
For 2018 you must have minimum essential coverage in order to avoid the tax penalty. There are still ways to do this and you can get a quote by contacting our team.
In 2019, options will change drastically. You will be able to obtain insurance of any type without the fear of facing a tax penalty or can even opt to go with no coverage at all.
If you have questions about this, want to know your options, or have general questions about healthcare, feel free to contact my team today.
H.R.1 — 115th Congress (2017-2018)
If you have missed the open enrollment period for the Healthcare.gov marketplace that does not mean you cannot get insurance coverage for 2018. There are many options to get coverage for the New Year, including avoiding the 2018 ACA Penalty.
Because you missed the deadline you do not have as many options and will not be eligible for a subsidy but you can get affordable coverage by contacting an agent/broker to assist you with a plan.
Our company has plans available that will satisfy the ACA law requirements for coverage and get your comprehensive coverage for the 2018 plan year.
Get a quote today!