What you don’t know might cost you!

The air has already gotten a bit crisper on some of my morning walks. While that may mean apples and candy corn for some, it also signals open enrollment for health insurance for many of us.

We have the most complicated healthcare system in the world, largely because of the role insurance plays. Insurance is a legal contract and for non-attorneys, the language is crazy-making if you even read the fine print (and most of us don’t).

Knowing even a few key things about health insurance can make the difference between feeling in control and finding yourself facing unexpected bills.

OK, it’s not as sexy as the Top 10 places to travel in 2019, but if you want to test yourself on our Top 10 Health Insurance Questions to see how you stack up, give it a try!

 

Test yourself. True or False?

 

1. If I don’t follow the open enrollment instructions for my plan, my coverage could be dropped.

 

2. If I don’t have health insurance, a hospital is obligated to care for me without charge.

 

3. If I miss a monthly premium payment, I can make it up next month.

 

4. Long Term Care Insurance is the same as Long Term Disability Insurance.

 

5. I can add a family member (spouse or child) to my insurance coverage only during open enrollment.

 

6. If I have to change insurance coverage during the year, my deductible carries over from the first insurance.

 

7. Health insurance generally costs more the older I am.

 

8. The government pays insurance agents who sell insurance plans.

 

9. If I move I can keep my health insurance plan.

 

10. The majority of Americans have trouble defining the four basic terms of health care insurance: co-pay, co-insurance, deductible, and out of pocket maximum.

 

Answers:

1. True. Whether you get your insurance through your employer or through the individual market, if you don’t follow the instructions for open enrollment, it is possible your coverage could be dropped or reduced significantly.
2. False. A hospital is only obligated to provide emergency care. A hospital doesn’t have to provide free care if you don’t have insurance unless you meet their financial guidelines.
3. False. Health insurance policy premiums have a due date, usually the last day of the month for coverage for the next month. Most policies have a “Grace Period” a number of days you can be late with your payment and still keep your policy. Ten days is a typical grace period. If you miss that grace period insurers can and will terminate your policy and don’t have to reinstate it no matter how good your reason is for missing the payment. It’s a good reason to set up automatic payments.
4. False. Long Term Care insurance provides reimbursement for care in your home or a facility. Long Term Disability insurance provides income replacement (usually 50-70% of your monthly income) for a period of time when you aren’t able to work. Long Term Care insurance is most often purchased by individuals, although some employers also offer policies as an employee benefit. Long Term Disability Insurance is most often provided by an employer but can also be purchased on your own.
5. True. Unless there’s been a change (Marriage, divorce, birth of a child) generally additions to your insurance coverage can only be made during open enrollment.
6. False. When you change insurance during the year, your deductible starts over with the new policy.
7. True. The older we are the more likely we will need to access health care so virtually all health insurance policy premiums increase with age.
8. False. The insurance company pays the representative their commission for selling a plan, if any commission is paid at all. If you are on Medicare, be aware that generally insurance agents are paid higher commissions to sell Medicare Advantage plans than Medicare supplements and drug plans.
9. It depends. Many plans have defined service areas and no coverage outside those service areas. A change of residence may require changing plans.
10. True. Before the launch of the Affordable Care Act, a Kaiser Family Foundation study showed that only 14% of Americans could define the terms that help them manage their health insurance.

 

How did you do? If any of these questions surprised you, didn’t make sense, or touch a situation you may be facing, please call the office for a free 15 minute consultation. We’re here to help.