Having the right health insurance is important to ensure you get the care you need at the most affordable price. With several options available through the Affordable Care Act (ACA) Marketplace, we at Lee Health would like to provide some tips to keep in mind when signing up for health insurance through the ACA Marketplace.
Tip 1
You can sign up through the website or through an agent or broker (and it’s free to work with an agent or broker).
When choosing an ACA plan, you can choose to sign up directly through the ACA website or you can choose to use an agent or broker to assist you. Many people don’t realize that using an agent or broker is free; they are paid for by the insurance companies. If you use an agent or broker, make sure they can offer you all the ACA options available to you.
Tip 2
Make sure the amount you owe when you go to the doctor or hospital is something you can afford.
Right now, many people qualify to have all or most of their premium paid by the government. Even if you don’t have to pay the full premium, make sure the amount you will have to pay when you go to the doctor or hospital is something you can afford.
Tip 3
Make sure you can get help where you want help; don’t let the insurance plan decide for you.
In-exchange health insurance plans sometimes don’t include the doctors or hospital you need for your treatment. Some insurance plans force you to use virtual doctors who are not local to you. Here are some ways you can check to make sure you can get help where you want it:
- Check the online directory of insurance plans.
- Call the plans customer service.
- Check directly with the hospital and doctors office.
- Check the benefits to see if you can go to a local doctor or if you need to use a virtual doctor.
Remember that if you don’t see the provider’s name, they are most likely not in the plan network and you may want to consider a different plan. A hospital or doctor may be included in one plan but not another from the same insurance company.
Tip 4
Check that the plan covers the prescription drugs you take.
If you take prescription drugs, make sure the plan you’re considering covers the drugs you take. You can usually check online which drugs are included in a health plan form.
Tip 5
Enrollment usually occurs in the fall, but it is possible to enroll for the insurance after the expiration if certain life events occur.
Your chance to get ACA market insurance usually occurs in the fall. However, if you miss the deadline, you may still be able to sign up if you encounter certain life events. You may also be eligible to change insurance plans outside your enrollment period, so if you’re not happy with the plan you’re on, check with a health insurance agent or broker to see if you can enroll or change outside your enrollment period. enrollment open .
Lee Health is pleased to be a part of many of the plans on the ACA market and we welcome you to ask any questions you have about health insurance. We know that health insurance can be confusing, and it’s worth taking the time to find the best option for you.
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Larry Antonucci, MD, MBA is the president and CEO of Lee Health, Southwest Florida’s premier health care destination offering acute care, emergency care, rehabilitation and diagnostic services, health and wellness education and community outreach and advocacy programs. Visit LeeHealth.org to learn more.
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