For over 25 years of experience as top producing Georgia Individual Health Insurance agents, Holly takes the time to answer some of the most common and important questions that should be asked when looking at all of the individual health insurance options available.
Q: what and when is open enrollment and why can I not get insurance outside of it?
A: Open Enrollment is part of the Health Care Reform (HCR) mandate, it is the period of time that allows individuals to enroll in a plan, either on or off the marketplace. Open Enrollment ended on March 31, 2014 and opens back up on November 15, 2014 and will last until Febraury 15, 2015. Outside of open enrollment the government has tied the insurance companies hands and they cannot accept new applicants or dependent additons without a qualifying life event (to see a list of qualifying life events, click here.).
Q: When looking for health insurance, where should I begin? What is important to know?
A: We recommend first contacting us when deciding because there are several factors to decide on when selecting the best coverage for your needs. What is your budgeted amount? What deductible is best for you and your family? Do you think you qualify for a Subsidy or Tax Credit or do you know?
Q: Do I have to pay the deductible before I can see a Doctor?
A: If you enroll in an individual health insurance policy that has a copay for office visits, you should only have to pay the copay when seeing a physician for visits for medical problems. Charges for procedures that are performed that are considered "in-office surgeries" (ex. mole removals) will not be covered under the copay and will apply to the deductible, if not already met. Things considered preventative care (ex. pap tests, child immunizations, prostate screenings, etc.) are required by law that all ACA compliant plans cover at 100% in network and at no cost to you.
Q: What if I have pre-existing conditions?
A: Insurance companies can no longer deny you coverage or increase your premium based on pre-existing conditions. (Tobacco users may face up to a 50% surcharge on their premium)
Q: Does it cost more to use an individual health insurance agent instead of enrolling directly through the health insurance company?
A: In the past Insurance agents did not charge for their services because they were reasonably compensated directly by the carrier. However, due to the new Health Care laws, it has forced agents operating inside the individual market to begin charging a fee for their services. We wish we didn't have to, but in order to stay in business we must.
Q: What are the advantages of using an experience individual health insurance agent?
A: Since most individual health insurance agents sell plans from several different insurance companies, they should have access to pricing, benefits, and know the underwriting guidelines for the different companies. In the event of problems with billing, claims payment errors or questions, a reputable and experienced agent should be able to help you without automatically sending you to the insurance company. However, not all agents help with questions after the policy is issued, so be sure to ask. To clarify, Insurance Now is happy to help with all of those issues - remember, we strive to help you in the same manner that we would help our own family members.