Health Insurance Questions ( FAQ)

frequently asked questions

How much does insurance cost?

The price of insurance depends on a number of things; the state you live in, the size of the family on the policy, and your age! 

Do pre-existing conditions matter?

Yes and no. Some pre-existing conditions (depending on the severity) may disqualify for the private market; but you can still secure coverage through the ACA.

What’s the difference between public and private insurance?

The public market qualifies you based on income; the higher your income, the higher the cost of insurance. It is also more beneficial for major medical conditions.

The private market qualifies you based on health history; the healthier you are, the lower the price. It does not take income into consideration.

What is an HMO versus a PPO?

HMO plans are local plans that only cover you within your zip code area; you also need to see a primary doctor before being referred to a specialist.

PPO plans are a wider network, they cover you nationwide and you can go straight to a specialist without being referred first.

When will my coverage begin?

Generally, plans take 24-48 hours to start from the date of application. However, certain benefits may take up to 30 days to begin.

What is a deductible?

A deductible is a dollar amount that you must spend on medical expenses in order for your insurance to kick in. These can range anywhere from 0$ – $15,000 depending on your plan.

Can my boyfriend/girlfriend be on my policy?

No. You must be legally married in order to be on an insurance policy together.

What is the best Health Insurance?

That’s tough. It really depends on your situation, the best plan for you may not be the best plan for someone else; but generally PPO plans will allow you more flexibility and less limitations on usage.

What is the cheapest Health Insurance?

Health Share and Short Term plans cost less than your average premium, but these insurances are not full coverage. This means there is a cap on the benefits – or – the insurance only covers up to a certain amount and then you have to pay the rest out of your own pocket!

What is a Lifetime Max?

This means that your health insurance has a limit. During the course of your policy, your insurance will cover up to a certain amount and then you are responsible for paying the rest.

What is a Max out of Pocket?

This is an amount of money that you will need to pay in a worst case scenario (hospitalization) and the insurance will then cover the rest 100%

What is Open Enrollment?

This is the period of time from November to December when the public marketplace (ACA) is open for enrollment. If you miss this window; you will need to wait a year to sign up for insurance on the public market.

What if I lose coverage after Open Enrollment?

Losing coverage after the open enrollment deadline qualifies you for special enrollment; if you changed/lost a job, moved, or became pregnant – you can still enroll on the public market outside of the open enrollment period.